Use of Electronic Health Records for Addressing Overweight and Obesity in Primary Care

Overweight and obesity are highly significant clinical and public health issues, affecting more than two-thirds of adults in this country; however, primary care clinicians often do not document overweight or obesity or discuss weight management with their patients. The objectives of the proposed research are to develop and evaluate a set of tools within electronic health records (EHRs) to assist primary care clinicians with the diagnosis and treatment of overweight and obesity and to help patients manage their weight.

Study Overview

• Status: Completed
• Conditions: Obesity; Overweight
• Intervention / Treatment: Other: Obesity tools in the electronic health record

• Study Type: Interventional
• Enrollment (Actual): 65278
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Massachusetts
    • Boston, Massachusetts, United States, 02115
      • Brigham and Women's Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 20 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• All adult patients (ages >= 20 years) who have a visit at a primary care practice at Brigham and Women's Hospital during the intervention period

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Obesity tools in electronic health record; This arm will consist of a new set of tools within the electronic health record to help primary care clinicians address overweight and obesity with their patients.	Other: Obesity tools in the electronic health record; The intervention is a set of new tools within the Partners electronic health record that are designed to assist primary care clinicians with the assessment and management of overweight and obesity in their patients.
No Intervention: Standard care; This arm is standard care for overweight/obesity.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
weight change over 6 months	Change in weight from first visit during Stage 2 of intervention period until approximately 6 months later, among patients with BMI >= 25	Baseline, 6 months
weight change over 12 months	Change in weight from first visit during Stage 2 of intervention period until approximately 12 months later, among patients with BMI >= 25	Baseline, 12 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Documentation of height	Percentage of patients with height recorded in the electronic health record	Baseline, 6 months, 12 months
Documentation of weight	Percentage of patients with weight recorded in electronic health record within past year	Baseline, 6 months, 12 months
Documentation of body mass index	Percentage of patients with body mass index calculated in electronic health record within past year	Baseline, 6 months, 12 months
Diagnosis of overweight and obesity	Percentage of patients with BMI >= 25 with Overweight or Obesity on the Problem List in the electronic health record	Baseline, 6 months, 12 months
Management of overweight and obesity	Percentage of patients with BMI >= 25 with evidence of treatment for overweight or obesity in the electronic health record	Baseline, 6 months, 12 months

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Primary care clinician attitudes about management of overweight and obesity	Primary care clinician attitudes about management of overweight and obesity, assessed via an electronic survey	baseline, 12 months
Patient attitudes and behaviors around weight management	Patient attitudes, beliefs, and behaviors around weight management (including diet, physical activity)	baseline, 6 months

Collaborators and Investigators

• Sponsor: Brigham and Women's Hospital
• Collaborators: Boston Medical Center; Agency for Healthcare Research and Quality (AHRQ)
• Investigators: Principal Investigator: Heather J Baer, ScD, Brigham and Women's Hospital

Publications and helpful links

General Publications

• Baer HJ, Wee CC, DeVito K, Orav EJ, Frolkis JP, Williams DH, Wright A, Bates DW. Design of a cluster-randomized trial of electronic health record-based tools to address overweight and obesity in primary care. Clin Trials. 2015 Aug;12(4):374-83. doi: 10.1177/1740774515578132. Epub 2015 Mar 25.

Study record dates

Study Major Dates

• Study Start: December 1, 2011
• Primary Completion (Actual): December 1, 2013
• Study Completion (Actual): December 1, 2013

Study Registration Dates

• First Submitted: November 21, 2011
• First Submitted That Met QC Criteria: November 28, 2011
• First Posted (Estimate): November 29, 2011

Study Record Updates

• Last Update Posted (Estimate): April 29, 2014
• Last Update Submitted That Met QC Criteria: April 28, 2014
• Last Verified: April 1, 2014

More Information

Terms related to this study

• Keywords: Obesity; Primary care; Overweight; Weight; Body mass index
• Additional Relevant MeSH Terms: Overnutrition; Nutrition Disorders; Body Weight; Obesity; Overweight
• Other Study ID Numbers: K01HS019789 (U.S. AHRQ Grant/Contract)