An Evaluation of Primary Care Clinician Referrals for Behavioral Weight Loss Counseling

In the context of enrolling patients from primary care practices into a weight loss research study, this study describes the percentage of patients primary care clinicians (PCCs) considered appropriate for referral and study participation rates among those referred.

An electronic health record review identified 5322 patients aged 18 to 75 years with BMI ≥ 30 kg/m² as eligible for review by community, attending, and resident PCCs for referral to a weight loss study. Referrals and patient interest in participating in the study are reported overall and by PCC type.

The mean (SD) age was 53.1 (13.9) years, mean BMI 36.5 (6.2) kg/m², 41.5% were male, and 30.9% were African American. PCCs reviewed 3882 patients and referred 2762 (71.1%) to the study. Of 1120 not referred, 260 (23.2%) were not known well enough by PCCs to assess for referral. The most common reasons for not referring included too much comorbidity (171, 15.3%), psychological reasons (170, 15.2%), and non-English speaking (125, 11.2%). Among 1897 patients invited to participate, 676 (35.6%) expressed interest and 360 (19.0%) were enrolled.

PCCs referred 71.1% of their eligible patients. Among those referred, interest in participation was modest and enrollment was low.

ClinicalTrials.gov Identifier: NCT04302727.