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肥胖患者报告的 USPSTF 实践指南对临床医生体重减轻咨询的影响。

Impact of USPSTF practice guidelines on clinician weight loss counseling as reported by obese patients.

机构信息

University of Arkansas at Medical Sciences, Fay W. Boozman College of Public Health, Health Behavior and Health Education, USA.

出版信息

Prev Med. 2008 Oct;47(4):394-7. doi: 10.1016/j.ypmed.2008.06.002. Epub 2008 Jun 10.

Abstract

OBJECTIVES

This study assessed the impact of the US Preventive Services Task Force (USPSTF) guidelines recommending that clinicians provide weight loss counseling (WLC) to all their obese patients.

METHODS

Pre-guideline (n=5524) and post-guideline (n=11,569) datasets were constructed from 2000 and 2005 Behavior Risk Factor Surveillance System survey data from eleven states which administered the weight control module in both years. Responses from obese (BMI> or =30), non-pregnant adults who had a check-up in the previous year were analyzed to determine proportion reporting WLC in the two surveys. Associations of WLC with selected demographics and health characteristics were examined, as well as with reports of weight loss efforts.

RESULTS

Less than half of both pre- and post-guideline obese respondents reported receiving WLC from their clinician. There were no significant differences in adjusted odds of receiving WLC when comparing pre-guideline and post-guideline data. Obese respondents reporting WLC also had higher odds of reporting current efforts to lose weight compared to those reporting no WLC.

CONCLUSIONS

The results suggest the USPSTF obesity-related guidelines have had little impact on clinician WLC behavior. Interventions to improve WLC by clinicians for their obese patients should be developed as practice guidelines alone do not appear to elicit appropriate counseling behavior.

摘要

目的

本研究评估了美国预防服务工作组(USPSTF)建议临床医生为所有肥胖患者提供减肥咨询(WLC)的指南的影响。

方法

从 2000 年和 2005 年的十一个州的行为风险因素监测系统调查数据中构建了预指南(n=5524)和后指南(n=11569)数据集,这两个年份都进行了体重控制模块的调查。对肥胖(BMI>或=30)、前一年有体检的非孕妇成年人的调查回复进行了分析,以确定两个调查中报告 WLC 的比例。还检查了 WLC 与选定人口统计学和健康特征的关联,以及与减肥努力的报告。

结果

少于一半的肥胖受访者在预指南和后指南中都报告了从他们的医生那里接受 WLC。比较预指南和后指南的数据,接受 WLC 的调整后几率没有显著差异。报告接受 WLC 的肥胖受访者也更有可能报告目前正在努力减肥,而不是报告没有接受 WLC。

结论

结果表明,USPSTF 与肥胖相关的指南对临床医生的 WLC 行为几乎没有影响。应制定干预措施以改善临床医生为肥胖患者提供的 WLC,因为实践指南本身似乎并不能引起适当的咨询行为。

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