Predictors of attendance at an obesity clinic and subsequent weight change

BMC Health Services Research

Campbell Thompson²  Gary Wittert²  Paul Hakendorf¹  Lauren Cohen³  Emma Brook³ 

[1] Clinical Epidemiology, Flinders Medical Centre and Flinders University, Adelaide, South Australia, Australia;Department of Medicine, Royal Adelaide Hospital and University of Adelaide, Adelaide, South Australia, Australia;University of Adelaide, Adelaide, South Australia, Australia

关键词: Evaluation;    Obstructive sleep apnoea;    Rural residence;    Depression;    Attrition;    Body mass index;   

Others  :  1134071
DOI  :  10.1186/1472-6963-14-78

 received in 2013-08-21, accepted in 2014-02-13,  发布年份 2014

【 摘 要 】

Background

There is conflicting evidence regarding characteristics of patients most likely to have poor outcomes after referral to a multidisciplinary weight loss clinic. The aim of this study was to identify patient characteristics associated with poor attendance and poor weight outcomes at a weight management clinic based in an Australian tertiary hospital.

Methods

Patient characteristics including age, sex, referral source, postcode of residence, weight, body mass index (BMI) and the presence of specific comorbidities were recorded. Outcome measures included questionnaire return following referral (a requirement prior to a first appointment being scheduled), percentage of appointments attended and rate of weight change (kg/month). Continuous variables were expressed as mean ± standard deviation and compared using a t-test. Categorical data were presented as proportions and a chi-squared test was used to test significance. Statistical significance was set as p < 0.05.

Results

Of 502 patients referred to the Comprehensive Metabolic Care Centre (CMCC), 231 (46%) did not return their questionnaire. Patients referred by their GP, compared to those with only internal hospital referrals, were more likely to return their questionnaire (86.0% cf. 77.9%; p = 0.02) as were those who had their BMI recorded in their referral letter (58% cf 45% p = 0.011). 28.1% of patients attended half or less of their scheduled appointments at the CMCC but none of the parameters analysed was associated with attendance. Weight loss was associated with residence in a rural location (p = 0.016) and hypercholesterolaemia (p = 0.03) and weight gain was associated with obstructive sleep apnoea (p = 0.04).

Conclusions

A large proportion of the patients referred to a weight management clinic never had an appointment scheduled. Clinicians should not anticipate greater compliance in one patient demographic than another; all groups need focus, particularly at the referral stage, and likely poor compliance must be anticipated and better managed.

【 授权许可】

   
2014 Brook et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Australia’s health 2010. Australia’s health series http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=6442452962 webcite
• [2]Overweight/obesity http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/4125.0main+features3330Jan%202013 webcite
• [3]The growing cost of obesity in 2008: three years on http://www.diabetesaustralia.com.au/PageFiles/7830/FULLREPORTGrowingCostOfObesity2008.pdf webcite
• [4]Hickson M, Macqueen C, Frost G: Evaluation of attendance and weight loss in an intensive weight management clinic compared to standard dietetic care. J Hum Nutr Diet 2009, 22(1):72-76.
• [5]Donini LM, Savina C, Castellaneta E, Coletti C, Paolini M, Scavone L, Civale C, Ceccarelli P, Zaninotto S, Tineri M, et al.: Multidisciplinary approach to obesity. Eat Weight Disord 2009, 14(1):23-32.
• [6]Elte JW, Castro Cabezas M, Vrijland WW, Ruseler CH, Groen M, Mannaerts GH: Proposal for a multidisciplinary approach to the patient with morbid obesity: the St. Franciscus hospital morbid obesity program. Eur J Int Med 2008, 19(2):92-98.
• [7]Inelmen EM, Toffanello ED, Enzi G, Gasparini G, Miotto F, Sergi G, Busetto L: Predictors of drop-out in overweight and obese outpatients. Int J Obes (Lond) 2005, 29(1):122-128.
• [8]Teixeira PJ, Going SB, Houtkooper LB, Cussler EC, Metcalfe LL, Blew RM, Sardinha LB, Lohman TG: Pretreatment predictors of attrition and successful weight management in women. Int J Obes Relat Metab Disord 2004, 28(9):1124-1133.
• [9]Honas JJ, Early JL, Frederickson DD, O’Brien MS: Predictors of attrition in a large clinic-based weight-loss program. Obes Res 2003, 11(7):888-894.
• [10]De Panfilis C, Cero S, Dall’Aglio E, Salvatore P, Torre M, Maggini C: Psychopathological predictors of compliance and outcome in weight-loss obesity treatment. Acta Biomed 2007, 78(1):22-28.
• [11]Jensen CD, Aylward BS, Steele RG: Predictors of attendance in a practical clinical trial of two pediatric weight management interventions. Obesity (Silver Spring) 2012, 20(11):2250-2256.
• [12]An introduction to Socio-Economic Indexes for Areas (SEIFA) http://www.abs.gov.au/ausstats/abs@.nsf/cat/2039.0 webcite
• [13]Binks M, O’Neil MP: Referral sources to a weight management program: relation to outcome. J Gen Int Med 2002, 17(8):596-603.
• [14]Guideline for the non-surgical management of hip and knee osteoarthritis http://www.racgp.org.au/download/documents/Guidelines/Musculoskeletal/racgp_oa_guideline.pdf webcite
• [15]Friedman SM, de Vergel Dios J, Hanneman K: Noncompletion of referrals to outpatient specialty clinics among patients discharged from the emergency department: a prospective cohort study. CJEM 2010, 12(4):325-330.
• [16]Lee VJ, Earnest A, Chen MI, Krishnan B: Predictors of failed attendances in a multi-specialty outpatient centre using electronic databases. BMC Health Serv Res 2005, 5:51. BioMed Central Full Text
• [17]Williams NA, Coday M, Somes G, Tylavsky FA, Richey PA, Hare M: Risk factors for poor attendance in a family-based pediatric obesity intervention program for young children. J Dev Behav Pediatr 2010, 31(9):705-712.
• [18]Spikmans FJ, Brug J, Doven MM, Kruizenga HM, Hofsteenge GH, der van Bokhorst-van Schueren MA: Why do diabetic patients not attend appointments with their dietitian? J Hum Nutr Diet 2003, 16(3):151-158.
• [19]Paterson BL, Charlton P: Non-attendance in chronic disease clinics: a matter of non-compliance? J Nurs Healthc Chronic Illn 2010, 2(1):63-74.
• [20]Mitchell AJ, Chan M, Bhatti H, Halton M, Grassi L, Johansen C, Meader N: Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies. Lancet Oncol 2011, 12(2):160-174.
• [21]Luppino FS, de Wit LM, Bouvy PF, Stijnen T, Cuijpers P, Penninx BW, Zitman FG: Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry 2010, 67(3):220-229.
• [22]Juel K, Christensen K: Are men seeking medical advice too late? Contacts to general practitioners and hospital admissions in Denmark 2005. J Public Health (Oxf) 2008, 30(1):111-113.
• [23]Galdas PM, Cheater F, Marshall P: Men and health help-seeking behaviour: literature review. J Adv Nurs 2005, 49(6):616-623.
• [24]Ong CW, O’Driscoll DM, Truby H, Naughton MT, Hamilton GS: The reciprocal interaction between obesity and obstructive sleep apnoea. Sleep Med Rev 2013, 17(2):123-131.