title: Promoting weight maintenance with electronic health record tools in a primary care setting: Baseline results from the MAINTAIN-pc trial.
abstract: Maintaining weight loss is a significant challenge in combating obesity. The goal of Maintaining Activity and Nutrition through Technology-Assisted Innovation in Primary Care (MAINTAIN-pc) is to evaluate the use of tools delivered through an electronic health record (EHR) and patient portal, with or without health coach support, to help primary care patients maintain weight loss. EHR tools include flowsheets, standardized surveys, and secure patient messaging. Inclusion criteria were age 18-75years, voluntary 5% weight loss in the past 2years with prior BMI≥25kg/m2, and no bariatric procedures in past 5years. Participants were randomized 1:1 to tailored online coaching with EHR tracking tools (CC) or EHR tracking tools alone (TO). We screened 721 individuals between October 2013 and February 2015; 194 participants enrolled (98 CC; 96 TO). The most common reasons for not enrolling included lack of interest (56%), not meeting age or weight loss criteria (17%), and no verified prior weight loss (10%). At baseline, participants were 53.4 (SD 12.2) years old, 74% female, and 88% White; 95% reported moderate physical activity. Average weight and BMI at baseline were 189.1 (SD 42.1) lbs and 30.4 (5.9) kg/m2, respectively. Pre-weight loss BMI was 34.4 (SD 6.5) kg/m2. Participants lost an average of 11.3% (SD 6.6) of their body weight before enrolling. Demographic and clinical characteristics did not differ by randomized group. The study successfully identified and recruited primary care patients with recent voluntary weight loss for participation in a weight maintenance program that uses EHR-based tools.
authors.affiliation: University of Pittsburgh, Pittsburgh, PA 15213, United States. Electronic address: conroymb@upmc.edu.
authors.forename: Molly B
authors.initials: MB
authors.lastname: Conroy
authors.affiliation: University of Pittsburgh, Pittsburgh, PA 15213, United States.
authors.forename: Cindy L
authors.initials: CL
authors.lastname: Bryce
authors.affiliation: University of Pittsburgh, Pittsburgh, PA 15213, United States.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: McTigue
authors.affiliation: University of Pittsburgh, Pittsburgh, PA 15213, United States.
authors.forename: Dana
authors.initials: D
authors.lastname: Tudorascu
authors.affiliation: University of Pittsburgh, Pittsburgh, PA 15213, United States.
authors.forename: Bethany Barone
authors.initials: BB
authors.lastname: Gibbs
authors.affiliation: University of Pittsburgh, Pittsburgh, PA 15213, United States.
authors.forename: Diane
authors.initials: D
authors.lastname: Comer
authors.affiliation: University of Utah, Salt Lake City, UT 84112, United States.
authors.forename: Rachel
authors.initials: R
authors.lastname: Hess
authors.affiliation: University of Pittsburgh, Pittsburgh, PA 15213, United States.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Huber
authors.affiliation: University of Pittsburgh, Pittsburgh, PA 15213, United States.
authors.forename: Laurey R
authors.initials: LR
authors.lastname: Simkin-Silverman
authors.affiliation: University of Pittsburgh, Pittsburgh, PA 15213, United States.
authors.forename: Gary S
authors.initials: GS
authors.lastname: Fischer
mesh_terms: D000328:Adult; D000368:Aged; D000068959:Body Weight Maintenance; D003376:Counseling / Q000379:methods*; D057286:Electronic Health Records; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000628:therapy*; D050177:Overweight / Q000628:therapy; D011320:Primary Health Care / Q000379:methods*; D015431:Weight Loss