The Patient Outcomes Research To Advance Learning (PORTAL) Network Adult Overweight and Obesity Cohort: Development and Description

Young, Deborah Rohm; Waitzfelder, Beth; Arterburn, David; Nichols, Gregory A.; Ferrara, Assiamira; Koebnick, Corinna; Yamamoto, Ayae; Daley, Matthew F.; Sherwood, Nancy E.; Horberg, Michael A.; Cromwell, Lee; Lewis, Kristina H.

doi:10.2196/resprot.5589

Cited by 13 publications

(20 citation statements)

References 17 publications

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“…From these sites, a cohort of adults with overweight and obesity was constructed to enable large‐scale observational research across diverse clinical care settings. The development and description of this cohort have been previously published . For all sites except Denver Health, plan members aged > 18 years with at least 12 months of continuous membership between January 1, 2009, and December 31, 2015, who were not pregnant, and who had a weight and height recorded in the EHR during the inclusion period were identified.…”

Section: Methodsmentioning

confidence: 99%

Antiobesity Medication Use in 2.2 Million Adults Across Eight Large Health Care Organizations: 2009‐2015

Saxon

Iwamoto

Mettenbrink

et al. 2019

Obesity

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101

102

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Objective The aim of this study was to examine the prescribing patterns and use of antiobesity medications in a large cohort of patients using data from electronic health records. Methods Pharmacy‐ and patient‐level electronic health record data were obtained on 2,248,407 adults eligible for weight‐loss medications from eight geographically dispersed health care organizations. Results A total of 29,964 patients (1.3% of total cohort) filled at least one weight‐loss medication prescription. This cohort was 82.3% female, with median age 44.9 years and median BMI 37.2 kg/m2. Phentermine accounted for 76.6% of all prescriptions, with 51.7% of prescriptions being filled for ≥ 120 days and 33.8% filled for ≥ 360 days. There was an increase of 32.9% in medication days for all medications in 2015 compared with 2009. Higher prescription rates were observed in women, black patients, and patients in higher BMI classes. Of 3,919 providers who wrote at least one filled prescription, 23.8% (n = 863) were “frequent prescribers” who wrote 89.6% of all filled prescriptions. Conclusions Weight‐loss medications are rarely prescribed to eligible patients. Phentermine accounted for > 75% of all medication days, with a majority of patients filling it for more than 4 months. Less than one‐quarter of prescribing providers accounted for approximately 90% of all prescriptions.

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Section: Methodsmentioning

confidence: 99%

Antiobesity Medication Use in 2.2 Million Adults Across Eight Large Health Care Organizations: 2009‐2015

Saxon

Iwamoto

Mettenbrink

et al. 2019

Obesity

Self Cite

101

102

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show abstract

“…The PORTAL overweight/obesity cohort was previously described elsewhere . For this study, we included adults older than 18 years and, for all race/ethnicities except Asians, those with a body mass index (BMI; kg/m 2 ) ≥25.0 recorded in their electronic health record in 2012 or 2013.…”

Section: Methodsmentioning

confidence: 99%

“…15 The PORTAL overweight/obesity cohort was previously described elsewhere. 16 For this study, we included adults older than 18 years and, for all race/ethnicities except Asians, those with a body mass index (BMI; kg/m 2 ) ≥25.0 recorded in their electronic health record in 2012 or 2013. For Asians, we included those with BMI ≥23.0, using the World Health Organization overweight/obesity cut point recommendations for Asians.…”

Section: Data For This Study Come From Patient Outcomes Research To Amentioning

confidence: 99%

Associations of overweight/obesity and socioeconomic status with hypertension prevalence across racial and ethnic groups

Young

Fischer

Arterburn

et al. 2018

J of Clinical Hypertension

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Racial/ethnic disparities in the prevalence of diagnosed hypertension are persistent but may be partially explained by racial/ethnic differences in weight category and neighborhood socioeconomic status. The authors compared hypertension prevalence rates among 4 060 585 adults with overweight or obesity across 10 healthcare systems by weight category and neighborhood education level in geographically and racially diverse individuals. Data were obtained from electronic health records. Hypertension was defined as at least two outpatient visits or one inpatient hospitalization with a coded diagnosis. Logistic regression, adjusted for age, sex, and site, with two‐way interactions between race/ethnicity and weight category or neighborhood education, was used to examine the association between hypertension and race/ethnicity, with whites as the reference. Results documented that odds ratios for hypertension prevalence were greater for blacks, American Indians/Alaskan Natives, Asians, and Native Hawaiians/other Pacific Islanders compared with whites and lower for Hispanics in similar weight categories and neighborhood education levels. Although two‐way interactions were statistically significant, the magnitude of the odds of hypertension compared with whites did not substantially vary across weight or neighborhood education. Hypertension odds were almost double relative to whites for blacks and Native Hawaiians/other Pacific Islanders across most weight categories and all neighborhood education levels. Odds of hypertension were about 50% greater for Asians relative to whites across weight categories. Results suggest that other factors might be associated with racial/ethnic disparities in hypertension. More research is needed to understand the many factors that may contribute to variation in diagnosed hypertension across racial/ethnic groups with overweight or obesity.

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“…Aims of the project were to: 1) estimate the willingness of individuals to be contacted about research activities, as well as their response rate; 2) obtain information on the attitudes of parents and adults of child bearing age about research, including participation of their child/ren; 3) gain insight into participant attitudes about the use of gathered data for both local and national research; 4) explore the impact of various demographic factors on survey outcomes and survey response rate; 5) examine if there are differences between individuals across various weight classes; 5) determine if there are regional variations in all of the above. Although previous studies have been published on adult obesity using a PCORI funded CDRN [4], these studies were retrospective in nature reporting on the number of patients in the network who met certain criteria. In contrast, the GPC HMRFS not only gathered retrospective data on individuals who met certain specific inclusion criteria but also contacted a random group of individuals from this sub-sample at each site with a survey invitation.…”

Section: Gpc Member Sitesmentioning

confidence: 99%

Patient Engagement and Attitudes Toward Using the Electronic Medical Record for Medical Research: The 2015 Greater Plains Collaborative Health and Medical Research Family Survey (Preprint)

Davis¹,

Hanrahan²,

Bokov³

et al. 2018

Preprint

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Background: Electronic Health Records (EHRs) are ubiquitous and yet little is known about their use for prospective research purposes, and even less is known about patient perspectives regarding the use of the EHR for research.Objective: The aim of this paper is to report on the initial obesity project from the Greater Plains Collaborative (GPC) that is part of the Patient Centered Outcomes Research Institute (PCORI) National Patient Centered Clinical Research Network (PCORNet). The purpose of the project was to prospectively assess caregivers' willingness for their children to participate in medical research, and to assess their views regarding the use of the electronic health record for recruitment and data collection.Methods: The electronic health records (EHRs) of 10 Midwestern academic medical centers were used to select patients for a survey was designed to assess patient willingness to participate in research, as well as the use of their EHRs for research. Survey questions included questions regarding interest in medical research, as well as basic demographic and health information. A variety of contact methods were used.Results: A cohort of 54,269 patients was created and 3,139 (5.78%) responded. Completers were more likely to be female and Caucasian, although these and other factors differed significantly by site.Respondents were overwhelmingly positive about using EHRs for research.Conclusions: EHRs are an important resource for engaging patients in research, and our respondents concurred. However, this investigation had a very low response rate which varied by method of contact, geographic location, and respondent characteristics. But unlike other health studies, EHRs directed research can know with certainty the clinically observed characteristics of non-respondents and respondents. Thus reliable study estimates can be derived by weighting responses and over sampling difficult to reach subpopulations. These data suggest that EHRs are a promising new and effective tool for patient engaged health research.

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The Patient Outcomes Research To Advance Learning (PORTAL) Network Adult Overweight and Obesity Cohort: Development and Description

Cited by 13 publications

References 17 publications

Antiobesity Medication Use in 2.2 Million Adults Across Eight Large Health Care Organizations: 2009‐2015

Antiobesity Medication Use in 2.2 Million Adults Across Eight Large Health Care Organizations: 2009‐2015

Associations of overweight/obesity and socioeconomic status with hypertension prevalence across racial and ethnic groups

Patient Engagement and Attitudes Toward Using the Electronic Medical Record for Medical Research: The 2015 Greater Plains Collaborative Health and Medical Research Family Survey (Preprint)

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