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Patient use of weight-management activities: a comparison of patient and physician assessments.

ABSTRACT: Examine concordance between patient and physician assessments of patient self-reported use of weight-management activities.Analysis of baseline data from a randomized controlled trial of patient and physician interventions to improve patient-physician communication (41 physicians and 274 of their patients).A majority of patients reported regular exercise (55.6%) and efforts to lose weight, such as eating less (63.1%) while physicians only perceived one-third of patients as engaging in those activities (exercise, 36.6%; weight loss, 33.3%). Kappa scores indicated small agreement between patient and physician assessments of patient self-reported use of exercise, mean kappa 0.28 (range 0.15 to 0.40) and no agreement between patient and physician assessments of patient self-reported efforts to lose weight, mean kappa -0.14 (range -0.26 to -0.01). Obese patients were more likely than non-obese patients to report trying to lose weight or exercising regularly (p<0.05), but physicians were less likely to perceive obese patients as engaging in those activities (p<0.05).Primary care physicians differed considerably from their patients, especially obese patients, in their assessments of patient use of weight-management activities.These results highlight the importance of improving patient-provider communication about weight-management activities, particularly among obese patients.

SUBMITTER: Bleich SN

PROVIDER: S-EPMC2879463 | biostudies-other | 2010 Jun

REPOSITORIES: biostudies-other

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Patient use of weight-management activities: a comparison of patient and physician assessments.

Bleich Sara N SN Huizinga Mary Margaret MM Beach Mary Catherine MC Cooper Lisa A LA

Patient education and counseling 20100302 3

<h4>Objective</h4>Examine concordance between patient and physician assessments of patient self-reported use of weight-management activities.<h4>Methods</h4>Analysis of baseline data from a randomized controlled trial of patient and physician interventions to improve patient-physician communication (41 physicians and 274 of their patients).<h4>Results</h4>A majority of patients reported regular exercise (55.6%) and efforts to lose weight, such as eating less (63.1%) while physicians only perceiv ...[more]

PMID: 20193998

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Project description:ObjectiveTo assess the relationship between measures of disease assessment in patients with large vessel vasculitis.MethodsPatients with giant cell arteritis (GCA) or Takayasu arteritis (TAK) were recruited into a prospective, observational cohort. Assessments within the following outcomes were independently recorded: 1) patient-reported outcomes (Multidimensional Fatigue Inventory, patient global assessment of disease activity [PtGA], Short Form 36 health survey [SF-36], Brief Illness Perception Questionnaire), 2) physician global assessment of disease activity (PhGA), 3) laboratory outcomes (C-reactive protein [CRP] level, erythrocyte sedimentation rate [ESR]), and 4) imaging outcomes (PETVAS, a qualitative score of vascular 18 F-fluorodeoxyglucose-positron emission tomography activity).ResultsAnalyses were performed on 112 patients (GCA = 56, TAK = 56), over 296 visits, with a median follow-up of 6 months. Correlation network analysis revealed assessment measures clustered independently by type of outcome. PhGA was centrally linked to all other outcome types, but correlations were modest (ρ = 0.12-0.32; P < 0.05). PETVAS, CRP level, and PtGA were independently associated with clinically active disease. All 4 patient-reported outcomes strongly correlated with each other (ρ = 0.35-0.60; P < 0.0001). Patient-reported outcomes were not correlated with PETVAS, and only PtGA correlated with CRP level (ρ = 0.16; P < 0.01). Patients whose clinical assessment changed from active disease to remission (n = 29) had a corresponding significant decrease in ESR, CRP level, and PETVAS at the remission visit. Patients whose clinical assessment changed from remission to active disease (n = 11) had a corresponding significant increase in CRP level and PtGA at the active visit.ConclusionMeasures of disease assessment in large vessel vasculitis consist of independent, yet complementary, outcomes, supporting the need to develop composite outcome measures or a standard set of measures covering multiple types of outcomes.

Project description:BackgroundCollaboration between people with type 2 diabetes (T2DM) and their health care teams is important for optimal control of the disease and outcomes. Digital technologies could potentially tie together several health care-related devices and platforms into connected ecosystems (CES), but attitudes about CES are unknown.ObjectiveWe surveyed convenience samples of patients and physicians to better understand which patient characteristics are associated with higher likelihoods of (1) participating in a potential CES program, as self-reported by patients with T2DM and (2) clinical benefit from participation in a potential CES program, as reported by physicians.MethodsAdults self-reporting a diagnosis of T2DM and current insulin use (n=197), and 33 physicians whose practices included ≥20% of such patients, were enrolled in the United States, France, and Germany. We surveyed both groups about the likelihood of patient participation in a CES. We then examined the associations between patients' clinical and sociodemographic characteristics and this likelihood. We also described characteristics of patients likely to clinically benefit from CES use, according to physicians.ResultsCompared with patients in Germany and France, US patients were younger (mean age 45.3 [SD 11.9] years vs 61.9 [SD 9.2] and 65.8 [SD 9.4] years, respectively), more often female, more highly educated, and more often working full-time. In all, 51 (44.7%) US patients, 16 (36.4%) German patients, and 18 (46.3%) French patients indicated strong interest in a CES program, and 115 (78.7%) reported currently using ≥1 connected device or app. However, physicians believed that only 11.3%-19.2% of their patients were using connected devices or apps to manage their disease. Physicians also reported infrequently recommending or prescribing connected devices to their patients, although ≥80% (n=28) of them thought that a CES could help support their patients in managing their disease. The factors most predictive of patient likelihood of participating in a CES program were cost, inclusion of medication reminders, and linking blood glucose levels to behaviors such as eating and exercise. In all countries, the most common patient expectations for a CES program were that it could help them eat more healthfully, increase their physical activity, increase their understanding of how blood glucose relates to behavior such as exercise and eating, and reduce stress. Physicians thought that newly diagnosed patients, sicker patients-those who had been hospitalized for diabetes, were currently using insulin, or who had any comorbid condition-and patients who were nonadherent to treatment were most likely to benefit from CES use.ConclusionsIn this study, there was a high degree of interest in the future use of CES, although additional education is needed among both patients with T2DM and their physicians to achieve the full potential of such systems to improve self-management and clinical care for the disease.

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Patient use of weight-management activities: a comparison of patient and physician assessments.

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Patient use of weight-management activities: a comparison of patient and physician assessments.

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