Effect of implementing the 5As of Obesity Management framework on provider–patient interactions in primary care

Abstract

This study presents pilot data from the implementation and evaluation of an obesity management tool (5As of Obesity Management developed by the Canadian Obesity Network) in a primary care setting. Results show that the tool facilitates weight management in primary care by promoting physician-patient communications, medical assessments for obesity and plans for follow-up care. Obesity remains poorly managed in primary care. The 5As of Obesity Management is a theory-driven, evidence-based minimal intervention designed to facilitate obesity counselling and management by primary care practitioners. This project tested the impact of implementing this tool in primary care clinics. Electronic self-administered surveys were completed by pre-screened obese subjects at the end of their appointments in four primary care clinics (over 25 healthcare providers [HCPs]). These measurements were performed before (baseline, n = 51) and 1 month after implementing the 5As of Obesity Management (post-intervention, n = 51). Intervention consisted of one online training session (90 min) and distribution of the 5As toolkit to HCPs of participating clinics. Subjects completing the survey before and after the intervention were comparable in terms of age, sex, body mass index, comorbidities, satisfaction and self-reported health status (P > 0.2). Implementing the 5As of Obesity Management resulted in a twofold increase in the initiation of obesity management (19 vs. 39%, P = 0.03), and caused a statistically significant increase in the perceived follow-up/coordination efforts (self-reported Patient Assessment of Chronic Illness Care components, 45 ± 22 vs. 67 ± 12 points, P = 0.002), as well as two components of the 5As framework: Assess (50 ± 29 vs. 66 ± 15 points, P = 0.03) and Assist (54 ± 26 vs. 72 ± 13 points, P = 0.01). Our results suggest that using the 5As of Obesity Management facilitates weight management in primary care by promoting physician-patient communications, medical assessments for obesity and plans for follow-up care.

Stigma and Knowledge as Determinants of Recommendation and Referral Behavior of General Practitioners and Internists

“…Future research should evaluate whether weight-related stigma not only affects recommendations but also how stigma in general might influence the quality of counseling (e.g., informed consent about possible risk related to surgery) or follow-up examinations by the physician. Possible intervention such as the B5As^of obesity should aim to inform HCPs with different backgrounds about bariatric surgery as a part of obesity management and to improve physician-patientinteraction in order to assure integrated treatment and counseling [37][38][39].…”

Telemedicine and primary care obesity management in rural areas – innovative approach for older adults?

“…Beneficiaries are required to lose 3 kg of weight during the first 6 months to remain eligible. Medicare requires the use and documentation of motivational interviewing using the 5 A’s approach (Assess, Advise, Agree, Assist, Arrange) [20] as well as measurement of height and weight at each visit.…”

Childhood Obesity

“…65 The Canadian Obesity Network has developed an office approach for clinicians to use with children with obesity: the 5A's of Obesity Management-Ask, Assess, Advice, Agree, and Arrange (Box 1). 66,67 This 5A approach has been used previously to address numerous other health interventions, including smoking cessation. 67 …”

“…66,67 This 5A approach has been used previously to address numerous other health interventions, including smoking cessation. 67 …”