The 5As team patient study: patient perspectives on the role of primary care in obesity management

BMC Fam Pract. 2017 Feb 8;18(1):19. doi: 10.1186/s12875-017-0596-2.

Abstract

Background: Over 60% of people have overweight or obesity, but only a third report receiving counselling from primary care providers. We explored patients' perspectives on the role of primary care in obesity management and their experience with existing resources, with a view to develop an improved understanding of this perspective, and more effective management strategies.

Methods: Qualitative study employing semi-structured interviews and thematic analysis, with a sample of 28 patients from a cohort of 255 patients living with obesity and receiving care to support their weight management in a large Primary Care Network of family practices in Alberta.

Results: Four illustrative themes emerged: (1) the patient-physician relationship plays an important role in the adequacy of obesity management; (2) patients have clear expectations of substantive conversations with their primary care team; (3) complex conditions affect weight and patients require assistance tailored to individual obesity drivers; (4) current services provide support in important ways (accessibility, availability, accountability, affordability, consistency of messaging), but are not yet meeting patient needs for individual plans, advanced education, and follow-up opportunities.

Conclusions: Patients have clear expectations that their primary care physician asks them about weight within a supportive therapeutic relationship. They see obesity as a complex phenomenon with multiple drivers. They want their healthcare providers to assess and address their root causes - not simplistic advice to "eat less, move more". Patients felt that the current services were positive resources, but expressed needs for tailored weight management plans, and longer-term follow-up.

Keywords: Family medicine; Obesity; Primary health care; Qualitative research.

MeSH terms

  • Adult
  • Alberta
  • Body Mass Index
  • Female
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Obesity / diagnosis
  • Obesity / therapy*
  • Obesity Management / organization & administration*
  • Patient Care Team / organization & administration*
  • Patient Compliance / statistics & numerical data
  • Patient Satisfaction / statistics & numerical data
  • Physician's Role*
  • Physicians, Primary Care
  • Primary Health Care / organization & administration*
  • Qualitative Research
  • Treatment Outcome