Satisfaction with primary care provider involvement is associated with greater weight loss: Results from the practice-based POWER trial

Wendy L Bennett; Nae-Yuh Wang; Kimberly A Gudzune; Arlene T Dalcin; Sara N Bleich; Lawrence J Appel; Jeanne M Clark

doi:10.1016/j.pec.2015.05.006

Satisfaction with primary care provider involvement is associated with greater weight loss: Results from the practice-based POWER trial

Patient Educ Couns. 2015 Sep;98(9):1099-105. doi: 10.1016/j.pec.2015.05.006. Epub 2015 May 27.

Authors

Wendy L Bennett¹, Nae-Yuh Wang², Kimberly A Gudzune³, Arlene T Dalcin⁴, Sara N Bleich⁵, Lawrence J Appel⁶, Jeanne M Clark⁷

Affiliations

¹ Welch Center for Prevention, Epidemiology and Clinical Research, The Johns Hopkins University, Baltimore, MD, USA; Department of Medicine, Division of General Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: wendy.bennett@jhmi.edu.
² Welch Center for Prevention, Epidemiology and Clinical Research, The Johns Hopkins University, Baltimore, MD, USA; Department of Medicine, Division of General Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: naeyuh@jhmi.edu.
³ Welch Center for Prevention, Epidemiology and Clinical Research, The Johns Hopkins University, Baltimore, MD, USA; Department of Medicine, Division of General Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: gudzune@jhu.edu.
⁴ Welch Center for Prevention, Epidemiology and Clinical Research, The Johns Hopkins University, Baltimore, MD, USA; Department of Medicine, Division of General Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: adalcin1@jhmi.edu.
⁵ Department of Health Policy and Management, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Electronic address: sbleich@jhsph.edu.
⁶ Welch Center for Prevention, Epidemiology and Clinical Research, The Johns Hopkins University, Baltimore, MD, USA; Department of Medicine, Division of General Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: lappel@jhmi.edu.
⁷ Welch Center for Prevention, Epidemiology and Clinical Research, The Johns Hopkins University, Baltimore, MD, USA; Department of Medicine, Division of General Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: jmclark@jhmi.edu.

Abstract

Objective: To evaluate the association between the patient-provider relationship, satisfaction with primary care provider's (PCP) involvement and weight loss in a practice-based weight loss trial.

Methods: POWER was a practice-based randomized controlled behavioral weight loss trial. Participants completed questionnaires about patient-provider relationship and satisfaction with their PCPs' involvement in the trial. PCPs completed a demographics and practice survey. The main outcome was the mean weight change from baseline to 24 months. We created mixed-effect models, accounting for the random effects of patients clustering with the PCP and the repeated outcome assessments within patient over time, and adjusted for randomization assignment, age, gender, race and clinical site.

Results: 347 (of 415) were included. Mean age was 54.8 years, mean BMI was 36.3 kg/m(2). Participants reported high quality patient-provider relationships (mean summary score=29.1 [range 14-32]). Patient-provider relationship quality was not associated weight loss in either the intervention or control groups. Among intervention participants, higher ratings of the helpfulness of the PCPs' involvement was associated with greater weight loss (p=0.005).

Conclusion: Patient-provider relationship quality was not associated with weight loss in a practice-based weight loss trial but rating PCPs as helpful in the intervention was associated with weight loss.

Practice implications: Partnering with PCPs to deliver weight loss programs may promote greater participant satisfaction and weight loss.

Trial registration: ClinicalTrials.gov NCT00783315.

Keywords: Obesity; Patient–provider relationship; Primary care provider.

Publication types

Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Communication*
Female
Humans
Male
Middle Aged
Obesity / physiopathology
Obesity / therapy*
Outcome Assessment, Health Care
Personal Satisfaction
Physician's Role*
Physician-Patient Relations*
Primary Health Care
Weight Loss
Weight Reduction Programs

Associated data

ClinicalTrials.gov/NCT00783315

Abstract

Publication types

MeSH terms

Associated data

Grants and funding