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Obesity: Provider Reminders

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What the CPSTF Found

About The Systematic Review

The CPSTF finding is based on evidence from a systematic review of 3 studies (search period 1966 to June 30, 2007).

The review was conducted on behalf of the CPSTF by a team of specialists in systematic review methods, and in research, practice, and policy related to obesity prevention and control.

Summary of Results

Detailed results from the systematic review are available in the CPSTF finding pdf icon [PDF - 127 KB].

The review included 3 studies that targeted providers with adult patients. No studies reported a connection between measured provider outcomes and obesity prevention or control.

  • Studies reported that physicians who received reminders were more like to do the following:
    • Record patients’ weight (1 study)
    • Document and treat overweight and obese patients (1 study)
    • Respond to reminders (1 study)

Summary of Economic Evidence

An economic review of this intervention was not conducted because the CPSTF did not have enough information to determine if the intervention works.

Applicability

Applicability of this intervention across different settings and populations was not assessed because the CPSTF did not have enough information to determine if the intervention works.

Evidence Gaps

The CPSTF identified several areas that have limited information. Additional research and evaluation could help answer the following questions and fill remaining gaps in the evidence base. (What are evidence gaps?)

Effectiveness on provider outcomes:

  • What effect do interventions have on providers' knowledge, attitudes, skills, and behavior?
  • Do interventions have an additional benefit on the provider's own weight?
  • Which characteristics of the interventions contribute to increased or decreased effectiveness?
  • Do different methods of delivery to providers produce different results?
  • What frequency, duration, or format of provider education contributes to increased or decreased effectiveness?
  • Are provider-based interventions more effective at preventing weight gain, preventing weight re-gain, or promoting weight loss?

Effectiveness on patient outcomes:

  • If the provider interventions change provider knowledge, attitudes, and skills, does this have an effect on patient knowledge, attitudes, and skills?
  • Do provider-level interventions have an effect on patient biological outcomes (such as weight-related outcomes, objectively measured)?
  • Do intervention effects vary when delivered to subgroups or sub-populations?

Implementation and adoption:

  • Are provider-level interventions more effective when used within clinical systems than when patients are referred to providers outside the system?
  • Do specific benefits of an intervention enhance its acceptability? For example, will training providers on obesity counseling assist with other types of counseling?
  • Are there other harms from an intervention, such as taking provider time away from other tasks that might be more effective?
  • What is the cost effectiveness of these interventions?
  • How broadly applicable is the intervention; to what types of patients does it apply?
  • What resources (e.g., time, money, staffing, computer capabilities) constrain these interventions?
  • In what ways can interventions be integrated into institutional or other system-level interventions?
  • Does effectiveness differ by the type of provider?
  • Does the level of scale affect whether interventions work?

Study Characteristics

  • All of the studies used electronic reminders.
  • None of the studies reported the same outcomes.
  • Study length was 1 year (in 1 study) and 2 years (in 2 studies).