Addressing obesity in the hospitalized patient: a needs assessment.
OBJECTIVE
To perform a needs assessment to determine the extent to which hospitalist providers recognize and intervene upon obese patients in the hospital setting.


METHODS
A chart review was performed for patients admitted to the hospitalist service at Johns Hopkins Bayview Medical Center between September 1 and October 1, 2008. Patient charts were reviewed for documentation of obesity and treatment plans were ordered and implemented. Demographic data for patients and hospitalist providers was also collected. Providers were also surveyed about their documentation practices related to obesity and any perceived barriers.


RESULTS
Forty-nine percent (136/276) of admitted patients were obese. Obesity was documented in 19% (26/136) of admission notes and a discrete plan was made to address obesity 7% (10/136) of the time. Hospitalist providers were more likely to document obesity in patients <60 years old (85% versus 55% respectively, P <0.007), and in patients with body mass indices (BMI) >or= 35 (77% versus 44% respectively, P < 0.004). Provider survey results suggest that providers do not document obesity because it is not considered to be an acute issue (67%), and they elect not to address obesity because they lack the time (63%), skill (37%), and they believe that their efforts will be unsuccessful (33%).


CONCLUSIONS
Documentation of obesity by hospitalist providers is poor. Because an inpatient admission has been characterized as a teachable moment when patients are willing to reflect on behavior change, this may be an ideal time to counsel and educate obese patients.
Howe
Erica E
EE
Division of Hospital Medicine, Johns Hopkins University, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA. ehowe3@jhmi.edu
Wright
Scott M
SM
Landis
Regina
R
Kisuule
Flora
F
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D015142:Baltimore; D003430:Cross-Sectional Studies; D003479:Curriculum; D004282:Documentation / Q000706:statistics & numerical data; D004501:Education, Medical; D020445:Hospitalists / Q000193:education / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data*; D006785:Hospitals, University; D006801:Humans; D008875:Middle Aged; D020380:Needs Assessment / Q000706:statistics & numerical data*; D009765:Obesity / Q000150:complications / Q000453:epidemiology* / Q000628:therapy*; D010819:Physician's Role; D010817:Physician-Patient Relations; D011320:Primary Health Care / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome