Year of Publication

2016

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Nancy Kloha

Clinical Mentor

Dr. Dianna Inman

Committee Member

Dr. Sharon Lock

Abstract

Purpose: The purpose of this study was to evaluate the current practices related to obesity in the primary care setting in University of Kentucky’s Healthcare System. The specific aims were to: 1) Determine the proportion of obese patients who had an ICD-9/10 diagnosis code for obesity, 2) Determine the proportion of obese patients who received interventions related to their obesity, 3) Determine whether obesity diagnosis and interventions varied based on patient demographics, and 4) Compare actual obesity interventions to those outlined in the clinical practice guidelines.

Methods: A retrospective chart review of male and female patients between the ages of 18 and 60 with BMI ≥ 30 was performed. A total of 100 charts of patients meeting inclusion/exclusion criteria between the years of 2013 and 2015 were randomly sampled. Patient demographics and characteristics were recorded into a spreadsheet in the secure Redcaps system, and exported into SPSS to analyze the data.

Results: Most of the differences in obesity-related interventions did not vary significantly based on the patient demographics of gender, race, obesity class, age, and whether comorbidities and family history were listed in the chart. However, some significant results were found. Of the charts reviewed, people with higher obesity classes were found to have a higher likelihood of having an ICD diagnosis code for obesity. Also, African American patients were more likely to have an ICD diagnosis code for obesity than Caucasians and Other races.

Conclusion: This study offers insight into possible gaps in managing obesity in primary care, as well as areas for further research. Providers should assess the weight and BMI of their patients, making sure that the appropriate recommendations are carried out based on clinical practice guidelines. Additional retrospective chart reviews with larger samples should be performed, as well as surveying providers to examine barriers to addressing obesity in primary care.