Can physicians accurately predict which patients will lose weight, improve nutrition and increase physical activity?
BACKGROUND
Physician counselling may help patients increase physical activity, improve nutrition and lose weight. However, physicians have low outcome expectations that patients will change. The aims are to describe the accuracy of physicians' outcome expectations about whether patients will follow weight loss, nutrition and physical activity recommendations. The relationships between physician outcome expectations and patient motivation and confidence also are assessed.


METHODS
This was an observational study that audio recorded encounters between 40 primary care physicians and 461 of their overweight or obese patients. We surveyed physicians to assess outcome expectations that patients will lose weight, improve nutrition and increase physical activity after counselling. We assessed actual patient change in behaviours from baseline to 3 months after the encounter and changes in motivation and confidence from baseline to immediately post-encounter.


RESULTS
Right after the visit, ~55% of the time physicians were optimistic that their individual patients would improve. Physicians were not very accurate about which patients actually would improve weight, nutrition and physical activity. More patients had higher confidence to lose weight when physicians thought that patients would be likely to follow their weight loss recommendations.


CONCLUSIONS
Physicians are moderately optimistic that patients will follow their weight loss, nutrition and physical activity recommendations. Patients might perceive physicians' confidence in them and thus feel more confident themselves. Physicians, however, are not very accurate in predicting which patients will or will not change behaviours. Their optimism, although helpful for patient confidence, might make physicians less receptive to learning effective counselling techniques.
Cancer Prevention, Detection and Control Research Program, Duke University Medical Center, Durham, NC 27705, USA. kathryn.pollak@duke.edu
Kathryn I
KI
Pollak
Cynthia J
CJ
Coffman
Stewart C
SC
Alexander
James A
JA
Tulsky
Pauline
P
Lyna
Rowena J
RJ
Dolor
Mary E
ME
Cox
Rebecca J Namenek
RJ
Brouwer
Michael E
ME
Bodner
Truls
T
Østbye
D000368:Aged; D003376:Counseling; D015444:Exercise / Q000502:physiology*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000178:diet therapy / Q000628:therapy*; D010349:Patient Compliance; D058007:Physicians, Primary Care; D011379:Prognosis; D036301:Qualitative Research; D040242:Risk Reduction Behavior; D015431:Weight Loss