Direct observation of weight-related communication in primary care : a systematic review

Abstract

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, 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.