Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Clin Obes. 2020 Oct;10(5):e12396. doi: 10.1111/cob.12396. Epub 2020 Aug 16.
Studies have documented that few patients with obesity receive evidence-based care. One provider characteristic that may impact clinical obesity care, but that has been under studied to date, is political party affiliation. This study sought to evaluate how primary care physicians (PCPs) report managing patients with obesity and assess whether there are differences between Democratic and Republican PCPs. This was a secondary analysis of a cross-sectional survey of 225 PCPs registered to vote as Democrats or Republicans in 29 US States. After reading a patient vignette, the PCPs reported the following outcomes: likelihood of documenting obesity in the medical record; likelihood of discussing obesity with the patient; and likelihood of engaging in eight different obesity management options. Almost all PCPs reported they would document obesity in the medical record (Republican = 97.6%, Democrat = 94.3%) and discuss it further (Republican = 95.2%, Democrat = 92.2%). Among eight obesity management options, PCPs were least likely to say they would prescribe medication (3.9%) or refer the patient to counselling (24.0%), regardless of political affiliation. Republicans were more likely to report that they would inquire about the time course of obesity (73.4% v. 56.2%, P = 0.012) and discuss health risks of obesity (91.0% vs 78.3%, P = .018). Republican and Democratic PCPs report some differences in managing patients with obesity, suggesting that political beliefs may play a role in some clinical care.
研究表明,很少有肥胖患者接受循证治疗。一个可能影响临床肥胖治疗的提供者特征,但迄今为止研究甚少,是政党归属。本研究旨在评估初级保健医生(PCP)如何报告管理肥胖患者,并评估民主党和共和党 PCP 之间是否存在差异。这是对 29 个美国州 225 名注册为民主党或共和党的 PCP 进行横断面调查的二次分析。在阅读患者病历后,PCP 报告了以下结果:在医疗记录中记录肥胖的可能性;与患者讨论肥胖的可能性;以及参与八种不同肥胖管理选项的可能性。几乎所有的 PCP 都表示他们会在医疗记录中记录肥胖(共和党=97.6%,民主党=94.3%)并进一步讨论(共和党=95.2%,民主党=92.2%)。在八种肥胖管理选项中,无论政治派别如何,PCP 最不可能表示他们会开处方(3.9%)或将患者转介给咨询(24.0%)。共和党人更有可能报告说他们会询问肥胖的时间进程(73.4%对 56.2%,P=0.012)和讨论肥胖的健康风险(91.0%对 78.3%,P=0.018)。共和党和民主党 PCP 在管理肥胖患者方面存在一些差异,这表明政治信仰可能在某些临床护理中发挥作用。