Impact of a Community-Based Weight Management Program in a North Carolina Health Care System.

BACKGROUND AND OBJECTIVES: Current strategies for obesity management in primary care leave many patients inadequately treated or unable to access treatment entirely. We aimed to evaluate a comprehensive, primary care clinic-based weight management program's clinical effectiveness in a community practice setting.  Methods:  This was an 18-month pre/postintervention study. We collected demographic and anthropometric data on patients enrolled in a primary care-based weight management program. The primary outcomes were percent weight loss postintervention and the proportion of patients who achieved a clinically significant total body weight loss (TBWL) of 5% or greater.  Results:  Our program served 550 patients over 1,952 visits from March 2019 through October 2020. A total of 209 patients had adequate program exposure, defined as four or more completed visits. Among these, all received targeted lifestyle counseling and 78% received antiobesity medication. Patients who attended at least four visits had an average TBWL of 5.7% compared to an average gain of 1.5% total body weight for those with only one visit. Fifty-three percent of patients (n=111) achieved greater than 5% TBWL, and 20% (n=43) achieved greater than 10% TBWL. CONCLUSION: We demonstrated that a community-based weight management program delivered by obesity medicine-trained primary care providers effectively produces clinically significant weight loss. Future work will include wider implementation of this model to increase patient access to evidence-based obesity treatments in their communities.

Pharmacist-coordinated multidisciplinary hospital follow-up visits improve patient outcomes.

BACKGROUND: The Affordable Care Act of 2010 allows for the adjustment of reimbursement to health care centers based on 30-day readmission rates. High readmission rates may be explained by multiple events at discharge, including medication errors that occur during the transition of care from inpatient to outpatient. Pharmacist involvement at discharge has been shown to improve health outcomes in patients with chronic disease; however, there is limited knowledge regarding the benefits of a clinic appointment with a pharmacist postdischarge. OBJECTIVE: To compare hospital readmission rates and interventions in a multidisciplinary team visit coordinated by a clinical pharmacist practitioner with those conducted by a physician-only team within an internal medicine hospital follow-up program. METHODS: A retrospective observational study was completed. Patients seen between May 2012 and January 2013 in 1 of the 2 hospital follow-up program models (multidisciplinary team or physician-only team) were included. RESULTS: A total of 140 patient visits were included for 124 patients. Patients seen by the multidisciplinary team had a 30-day readmission rate of 14.3% compared with 34.3% by the physician-only team (P=0.010). Interventions completed during the visits, including addressing nonadherence, initiating a new medication, and discontinuing a medication were also statistically different between the groups, with the multidisciplinary team completing these interventions more frequently. CONCLUSIONS: Hospital follow-up visits coordinated by the multidisciplinary team decreased 30-day hospital readmission rates compared with follow-up visits by a physician-only team.