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Wednesday, March 03, 2010
Patient use of weight-management activities: A comparison of patient and physician assessments

About this JournalSara N. Bleich, Mary Margaret Huizinga, Mary Catherine Beach and Lisa A. Cooper
Objective
Examine concordance between patient and physician assessments of patient self-reported use of weight-management activities.
Methods
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).
Results
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).
Conclusions
Primary care physicians differed considerably from their patients, especially obese patients, in their assessments of patient use of weight-management activities.
Practice implications
These results highlight the importance of improving patient–provider communication about weight-management activities, particularly among obese patients.
 
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