Clinical decision support to improve primary care obesity management in adults with diabetes: Clinic-randomized study...

To promote use of lifestyle, pharmacologic, and surgical weight management options for adults with body mass index (BMI) ≥35 kg/m² and type 2 diabetes (T2D), this project implements and evaluates a weight loss clinical decision support (WL-CDS) intervention that provides patient-specific estimates of the risks and benefits of evidence-based obesity management options to primary care clinicians (PCCs) and patients at primary care clinical encounters.

We randomize 38 primary care clinics to either (a) usual care (UC), or (b) the WL- CDS intervention that provides patients and PCCs recommendations for lifestyle changes and patient-specific obesity management options and estimates of benefits and risks of weight loss medications, or metabolic bariatric surgery (MBS) when indicated.

Outcomes assessed at 18-months after a patient-specific index date are (a) referral of eligible patients for MBS evaluation; (b) initiation or active management of FDA-approved medications for weight loss; and (c) weight trajectory. Outcomes measured within 1 month of index date are patient-reported (d) shared decision making about weight loss options, and (e) intention to engage in weight loss.

This study will deepen our understanding of how patients and PCCs use WL-CDS generated information to inform selection of obesity care options for adults with T2D and BMI ≥35 kg/m².