Practice patterns of nurse practitioners related to weight management in primary care

Abstract

Background and objectives: Obesity prevalence rates for adults are at an all-time high. This systematic review of the literature aimed to examine the practice patterns of nurse practitioners (NPs) related to weight management in primary care and recommend future areas of research as it relates to the diagnosis and management of patients with obesity by NPs. Data sources: The databases CINAHL PLUS with Full Text, Cochrane Central Register of Controlled Trials, ERIC, MEDLINE, PsycINFO, and SPORTDiscuss were searched. Conclusions: The initial search resulted in 169 articles. Fifteen peer-reviewed articles from 13 studies were included in the analysis. Four themes emerged from the analysis: approach to practice; the practitioner's role within the interdisciplinary team; communication; and resources and tools. Implications for practice: This review was conducted to better understand the challenges and facilitators to the management of patients with obesity in primary care. Future research between NPs and variables related to obesity are necessary to further identify areas for education, training, and policy development.

Identifying indicators sensitive to primary healthcare nurse practitioner practice: A review of systematic reviews

“…Education-Provider included five studies [ 31 , 32 , 64 , 69 , 70 ]. Provider knowledge was assessed for the use of the Australasian Triage Scale, patient counselling on obesity, skin cancer detection and training, early detection of skin cancer, and orientation in long-term care.…”

“…Interprofessional Team Functioning was examined in four reviews [ 32 , 44 , 52 , 69 ]. Providers expressed positive perceptions of high functioning interprofessional teams [ 69 ] and improved communication (McParland, 2022) (no p value reported) [ 52 ]. In their review on long-term care, Lovink et al stated that no provider outcomes were identified [ 32 ].…”

“…Prescribing included 15 reviews [ 10 – 12 , 28 , 29 , 32 , 34 , 43 , 44 , 48 , 56 , 59 , 60 , 68 , 69 ]. Significant results favouring NPs were found for the initiation, up-titration and target doses of beta-blockers (p < 0.001) [ 28 ], as well as for the prescription of cholinesterase inhibitors and antidepressants [ 34 ].…”

“…Equal to statistically significant results favouring the NP group were noted in the appropriateness of medication prescribing in two reviews [ 10 , 60 ], and prescribing diagnostic tests [ 12 ]. Under-prescribing of weight-loss pharmaceuticals was noted by Hyer [ 69 ]. Mixed results were noted in one review [ 44 ] where NPs prescribed equal to significantly more anxiolytics (p ˂ 0.001) and significantly more anti-depressants.…”

“…Scope of Practice was identified in six reviews [ 38 , 47 , 58 , 63 , 64 , 69 ]. Milesky and colleagues [ 47 ] reported that unrestricted or least restrictive scope of practice was mentioned in 7.35% of theme occurences in their sample.…”