Fritzenwallner Sabine, Flamm Maria, Wiesinger Hans-Peter, Schaffler-Schaden Dagmar
Master Programme Public Health, Center for Public Health and Healthcare Research, Paracelsus Medical University, Strubergasse 21, 5020, Salzburg, Austria.
Institute of General Practice, Family Medicine and Preventive Medicine, Center for Public Health and Healthcare Research, Paracelsus Medical University, Strubergasse 21, 5020, Salzburg, Austria.
Wien Klin Wochenschr. 2025 Jun 11. doi: 10.1007/s00508-025-02545-3.
Obesity is a chronic, multifactorial disease that is often described as an epidemic or pandemic of the 21st century. General practitioners (GPs) play a crucial role in managing it, yet multiple barriers hinder effective care. This study explores Austrian GPs' experiences in obesity management, their self-assessed knowledge and care competencies, and the perceived barriers to optimal treatment.
A quantitative online survey was conducted among GPs in October and November 2023. The questionnaire covered prevention, treatment, barriers, and experiences in managing overweight and obesity in primary care.
In all, 59 GPs (56% female) completed the survey. Nearly all recognized obesity as a chronic disease and felt responsible for its management, but almost half considered their training insufficient. While 80% acknowledged the need for multimodal therapy programs, awareness of available healthcare services was low. The most significant barrier to effective obesity care from the GP's point of view was a lack of patient motivation. Female GPs were more likely to screen for dietary habits and physical activity, refer patients to specialized care, and request additional resources, whereas male GPs were more likely to prescribe pharmacotherapy. More experienced GPs felt better trained but were less likely to seek treatment guidelines. Regional and practice-setting differences influenced attitudes and referral patterns. GPs with private insurance contracts felt best trained and were least likely to request additional support.
The survey revealed considerable uncertainty among GPs regarding the management of overweight and obesity. These findings highlight the need for targeted interventions to improve patient care and enhance GPs' training in obesity management.
肥胖是一种慢性多因素疾病，常被描述为21世纪的一种流行病或大流行病。全科医生（GPs）在管理肥胖方面起着至关重要的作用，但多种障碍阻碍了有效的治疗。本研究探讨了奥地利全科医生在肥胖管理方面的经验、他们自我评估的知识和护理能力，以及最佳治疗中存在的感知障碍。
2023年10月和11月对全科医生进行了定量在线调查。问卷涵盖了初级保健中超重和肥胖管理的预防、治疗、障碍和经验。
共有59名全科医生（56%为女性）完成了调查。几乎所有人都认识到肥胖是一种慢性病，并认为自己有责任对其进行管理，但近一半的人认为他们的培训不足。虽然80%的人承认需要多模式治疗方案，但对现有医疗服务的认知度较低。从全科医生的角度来看，有效肥胖护理的最大障碍是患者缺乏动力。女全科医生更有可能筛查饮食习惯和身体活动情况，将患者转诊至专科护理，并请求提供额外资源，而男全科医生更有可能开药物治疗处方。经验更丰富的全科医生感觉自己的培训更好，但寻求治疗指南的可能性较小。地区和执业环境差异影响了态度和转诊模式。签订私人保险合同的全科医生感觉自己的培训最好，且最不可能请求额外支持。
调查显示，全科医生在超重和肥胖管理方面存在相当大的不确定性。这些发现凸显了需要有针对性的干预措施来改善患者护理，并加强全科医生在肥胖管理方面的培训。
