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Direct observation of weight-related communication in primary care: a systematic review
Calum T McHale1, Anita H Laidlaw2, Joanne E Cecil2
1Population and Behavioural Health Sciences, School of Medicine, University of St Andrews, North Haugh, St Andrews, UK ctm2@st-andrews.ac.uk.
Background:
Primary care is ideally placed to play an effective role in patient weight management; however, patient weight is seldom discussed in this context. A synthesis of studies that directly observe weight discussion in primary care is required to more comprehensively understand and improve primary care weight-related communication.
Objective:
To systematically identify and examine primary care observational research that investigates weight-related communication and its relationship to patient weight outcomes.
Methods:
A systematic review of literature published up to August 2015, using seven electronic databases (including MEDLINE, Scopus and PsycINFO), was conducted using search terms such as overweight, obese and/or doctor-patient communication.
Results:
Twenty papers were included in the final review. Communication analysis focused predominantly on 'practitioner' use of specific patient-centred communication. Practitioner use of motivational interviewing was associated with improved patient weight-related outcomes, including patient weight loss and increased patient readiness to lose weight; however, few studies measured patient weight-related outcomes.
Conclusion:
Studies directly observing weight-related communication in primary care are scarce and limited by a lack of focus on patient communication and patient weight-related outcomes. Future research should measure practitioner and patient communications during weight discussion and their impact on patient weight-related outcomes. This knowledge may inform the development of a communication intervention to assist practitioners to more effectively discuss weight with their overweight and/or obese patients.
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