Abstract 399: Addressing Weight Goals In Patients With Coronary Artery Disease: A Dilemma At Resident Physician Clinic

Autor: Rosaline Ma, Sana Ahmad, Rebecca Mazurkiewicz
Rok vydání: 2020
Předmět:
Zdroj: Circulation: Cardiovascular Quality and Outcomes. 13
ISSN: 1941-7705
1941-7713
DOI: 10.1161/hcq.13.suppl_1.399
Popis: Background: Adults diagnosed as overweight (BMI 25-29.9 kg/m 2 ) or obese (BMI ≥30 kg/m 2 ) are at increased risk of ASCVD, heart failure, and atrial fibrillation compared with those of a normal weight. According to the 2011 ACC/AHA guidelines for secondary prevention of CAD, BMI should be assessed at every visit and clinicians should consistently encourage weight loss to their patients by promoting exercise, caloric intake and formal behavioral programs. Objective: To evaluate whether residents are following the 2011 ACC/AHA guidelines by identifying patients with CAD that are overweight/obese and counseling them regarding weight loss. Methods: We performed a retrospective chart review of patients with known diagnosis of CAD from January 2019-June 2019 at Lenox Hill Medical Associates. The inclusion criteria for this study was patients of all ages with a known diagnosis of CAD and BMI ≥ 25 who had at least 1 annual physical exam performed and had an assigned resident physician. We excluded patients who only visited the clinic for acute visits. We reviewed progress notes to see if patients’ weights were addressed and whether there was a plan discussed with the patient regarding weight loss. A survey was sent to PGY1-PGY3 residents to identify barriers to weight management. Results: Between January 2019-June 2019, a total of 87 patients with CAD and BMI ≥ 25 were evaluated in clinic. Out of these patients, only 23% (20 of 87) had their BMI addressed during the visit and most notes (12/20) did not document a weight loss plan for patients. For those patients who received weight loss counseling, 13 out of 20 of them had BMI above 35. Based on an anonymous survey sent to PGY1-PGY3 residents, only 19% (7 of 36) residents reported that they addressed patients' weight at an annual visit. More than 60% of our residents identified time as the biggest barrier to accomplishing weight goals in CAD patients. Conclusion: This retrospective chart review showed that less than a quarter of our patients with the diagnosis of CAD and BMI ≥25 had their weight addressed during their visits at our resident physician clinic. Overall, patients with a higher BMI were more likely to be identified as obese with a higher likelihood of getting counseled on weight loss. Based on our survey, the biggest barrier to counseling patients is time. Due to these missed opportunities of educating our patients on weight goals, we are increasing their risk of complications in the future. We are currently developing time efficient strategies to help residents improve the process of educating and documenting patient specific weight loss plans.
Databáze: OpenAIRE
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