Implementation of a clinical practice guideline in a primary care setting for the prevention and management of obesity in adults.

Over two-thirds of American adults have obesity or overweight, increasing the risk of comorbidities, mortality, and healthcare costs. Despite this growing issue, screening and counseling for an unhealthy weight are not common in primary care and clinical practice guidelines (CPGs) for prevention and management of obesity are underutilized. Following the stepwise approach outlined in the Registered Nurses' Association of Ontario Toolkit: Implementation of Best Practice Guidelines, the Institute for Clinical Systems Improvement: Prevention and Management of Obesity for Adults were implemented in a primary care office in Lexington, KY. Education was implemented with providers and staff. An assessment of readiness for change was completed at check-in and customizable phrases were built into the electronic health record. After a 12-week implementation, providers were consistently assessing for comorbidities, setting goals, and managing weight in those with obesity using evidence-based strategies. Readiness for change was being documented in less than 40% of those patients. For those with overweight providers were assessing readiness for change in only 30% of patients and were setting goals in just over 40% of patients. After the implementation, care more closely followed the CPG but additional steps are necessary to improve the prevention and management of obesity in this population.