Measuring What Matters: Beyond Quality Performance Measures in Caring for Adults with Obesity

Abstract

Obesity is a chronic disease that poses serious health and societal burdens. Although guidelines exist for obesity management in primary care, evaluating the success of obesity treatment programs is hampered by lack of established, robust quality measures. This study aimed to develop, and test for feasibility, measures for operational tracking, quality performance, and patient-centered care in the context of a national collaborative to develop a model for obesity management in the US primary care setting. The authors developed and evaluated 7 measures used to track the care of patients with overweight or obesity (n = 226,727 at baseline) receiving care within 10 health care organizations (HCOs). Measure categories included: (1) operational tracking (obesity/overweight prevalence and prevalence of obesity-related complications); (2) quality performance (obesity diagnosis, change in weight over time, anti-obesity medication prescriptions, and assessment of obesity-related complications); and (3) patient-centered care (patient-reported outcomes). Measures were tested for feasibility, variability across HCOs, ability to detect differences over time, and value to the HCOs. All measures were feasible to collect, provided value to the participating HCOs, and demonstrated variation and ability to detect differences over time (eg, rates of documented diagnosis of obesity classes 1, 2, and 3 increased from 29%, 46%, and 66%, respectively, at baseline to 35%, 53%, and 71% at study end). This study confirmed the feasibility and perceived value of 7 operational, performance, and patient-centered measures collected in primary care practices in 10 HCOs over an 18-month period.

Weight-biased attitudes about pediatric patients with obesity in Dutch healthcare professionals from seven different professions

“…Third, it is suggested to reduce the focus on body weight as the treatment target. Preferably a combination of clinical characteristics, health indices, and patient-reported outcome measures is used, including quality of life ( Ciemins et al, 2021 ). Fourth, education on patient-centered communication strategies, including motivational interviewing and use of carefully chosen weight-related terminology, is advised to implement as mandatory course in training programs of HCPs ( Mikhailovich and Morrison, 2007 ; Bradbury et al, 2018 ; Serban et al, 2021 ; Stuij et al, 2020 ; Van Maarschalkerweerd et al, 2020 ; Nnyanzi, 2016 ).…”

Building Successful Models in Primary Care to Improve the Management of Adult Patients with Obesity

“…Results of the measure development work are reported elsewhere. 18 One of the measures developed in this collaborative, obesity diagnosis, went through a formal testing process to ultimately prepare it for endorsement by the National Quality Forum (S.L. Sampsel, personal communication).…”