Primary Care Intervention Strategies
OVERVIEW
The primary purpose of this survey is to increase consultations for weight management through indirect and non-discriminative means, capitalizing on multidisciplinary approaches to assist with weight loss and management that include and highlight the role of the GP. The strategy takes into account potential barriers to discussions about weight management at the primary care level. These include: time limitations on both patient and doctor’s part, lack of motivation and lack of communication between both parties, lack of resources and support staff, fear of negative patient reactions, and lack of weight management skills and confidence by doctor.
The secondary purpose of this survey is to increase patient confidence at the primary care level regarding weight management through education, care, and established clinical partnerships that promote the GP’s position and ownership of the patient’s directed pathway. This strategy supports the need for a local established clinical facility that embraces a multidisciplinary approach for overweight and obese patients who do not have an existing disease, whilst continuing to support those presenting with co-morbidities. WeightLoss Solutions Australia is a facility that currently embraces this approach and provides non-surgical and surgical intervention to assist patients with eating and/or weight related concerns.
PROCESS
The survey takes less than 5 minutes to complete and should be voluntarily completed by all adult patients (18 and above) (non-discriminately) visiting the clinic whilst they are waiting to see their GP. Completed surveys should be returned to patient liaison staff and supplied to the GP for a quick review during the patient’s consultation or filed for future reference or review at a later date. By quickly reviewing the responses on the survey, the GP can request if the patient would like to book a weight management consultation to discuss the concerns outlined on the survey.
Given that little time may be available to address the concerns on the survey, along with those presented for that day’s consultation, it is advisable that the weight management consultation be offered as a separate appointment. GPs can then discuss in detail the responses outlined on the survey with suggestions for further assessment or assistance. Our psychologist is happy to train patient liaison staff and doctors on administration and assessment protocols regarding this short survey at no cost.
Patients wishing to take action and learn more about non-surgical weight loss options, like the Orbera Intragastric Balloon, or surgical options for weight loss, as indicated on the survey, will be given the opportunity to consult with a bariatric consultant from WeightLoss Solutions Australia at no cost to the patient*. Patients should view their consultation with a bariatric consultant as an opportunity to ask any specific questions they may have regarding options for weight loss and management. They will also be given the opportunity to discuss any psychological or dietary concerns related to their weight problems. Should the GP see the need for further assessment regarding the patient’s eating habits and attitudes, or health habits and psychosocial functioning, prior to suggestions for weight loss, our psychologist can assist the GP with further testing at no cost to the patient. *Consultation bulk billed under Medicare
UNDERSTANDING THE SURVEY
This mini survey has been designed using a number of statements and constructs related to concerns about eating habits, dietary habits, and weight, along with statements related to patient perception and readiness to change. The survey has 6 constructs in total and responses to the 25 statements on the survey will provide GPs with valuable information regarding their patient’s concerns. The survey has not been tested for reliability or validity and should be used as a guide only to make provisions for future consultations regarding weight loss and management. The constructs and the statements that make up these constructs are outlined below.
1. Over Eating (Items 1, 5, 7, 13, 16, 21). Statements refer to one’s tendency to continue eating following satiety. High scores (<4) in this construct indicate that the patient may actually be aware of their over eating habits and a weight loss program for this particular patient should include some behavioral alternatives to these habits. Weight loss surgery will give the patient forced behavior modification; however, the patient may also benefit from psychological intervention, coupled with a non-surgical program and dietary intervention, to assist them with behavioral changes. A consultation with our psychologist will help in making a formal diagnosis regarding the patient’s eating habits and attitudes.
2. Emotional Eating (Items 2, 8, 14, 19, 20, 23). Statements refer to emotional regulation as an expectation and consequence of eating. High scores (<4) in this construct indicate the patient would benefit from alternative coping strategies, cognitive and behavioral, to assist them in dealing with emotional stressors and such strategies should be part of their weight loss program. A consultation with our psychologist will help in making a formal diagnosis regarding the patient’s eating habits and attitudes.
3. Readiness for Change (Items 3, 9, 15). Statements are related to acknowledgement of a problem and a commitment to seeking assistance. These statements are specific and should give GPs an opportunity to open discussions about the concern/s with suggestions for further assistance, depending on the nature of the concern-whether psychological, dietary, or weight related. We are able to assist you with specialists for any of these concerns.
4. Action (Items 4, 17, 25). Statements are related to an interest in a specific assessment or procedure. These statements are also specific and should give the GPs an opportunity to open discussions about the concern/s with suggestions for further assistance. We are able to assist you with a dietitian and/or bariatric consultant for any action the patient wishes to take. There are a number of non-surgical options for patients, including the Orbera System Balloon, Formulated Meal Replacements, or Diet Plate. There are also a number of surgical options, including a gastric band and lap-sleeve gastrectomy.
5. Motivation for Weight Loss (Items 10, 12, 18, 24). Statements refer to an individual’s level of motivation to lose weight. High scores (<2) indicate the patient is ready to invest time and energy into losing some weight. This should provide GPs with an opportunity to assist the patient further with their weight loss goals by exploring the available options with them, as well as investigating previous weight loss attempts and considerations. Patients can then be encouraged to seek further information regarding options available at Circle of Care Queensland and investigate procedures suitable to their goals and expectations.
6. Patient Perception (Items 6, 11, 22). Statements point to patient perceptions regarding the role of their GP in weight management. Understanding the perceptions of your patients regarding your role in managing their weight will not only give you some indication as to where you stand with your patients on the subject, but may also highlight some of the psychological barriers to discussions about weight management. GPs may find this a valuable personal reference and may see this as an opportunity to remove some of these barriers.
Assessing the results of the survey is very easy; and, our psychologist is happy to visit your clinic to provide free training on administration and assessment protocols.
