Description
The aims of the study are:
1. To identify patients with obesity alone versus with the obesity-hypertension-depression constellation, using over 10 years of retrospective EpicCare EHR data. Although we are primarily interested in patients with all three conditions and tracking their progression, we recognize that few patients go directly from being healthy to having all three conditions. The timing of occurrence may also have clinical and treatment implications. For example, depression followed by obesity and then hypertension may be appropriately managed with an initial focus on the depression rather in contrast to obesity followed by hypertension and then depression, in which weight management may take priority. These progressions, as well as the proportion of patients with each of the three components of the constellation, may differ by age, sex, and race.
2. To examine the effectiveness of an intensive lifestyle intervention for patients living with various combinations of the three priority conditions. The intervention is currently being delivered in a randomized controlled trial, entitled “Evaluation of Lifestyle Interventions to Treat Elevated Cardiometabolic Risk in Primary Care (E-LITE), jointly funded by NIDDK and American Heart Association and led by Jun Ma, MD, PhD. (Dr Ma is a co-investigator of the Trends Study.) Some of these patients will also have hypertension and depression. We will test if the presence of hypertension and/or depression affects the effectiveness of E-LITE interventions in reducing obesity and cardiometabolic risk.
3. To assess how well the sample of patients and physicians in E-LITE represents the patients and physicians in clinics of the Palo Alto Medical Foundation (PAMF). We will compare characteristics of patient participants in E-LITE with non-participating patients who also have obesity. As with any randomized interventional trial, there are concerns about the degree to which the patients enrolled in the trial are representative of those in a larger population who would otherwise meet the inclusion/exclusion criteria. For example, patients willing to be randomized and participate in the intervention, and consent, and data collection processes may be more adherent than other patients. By accessing data from the EHR from both E-LITE participants and (with de-identified data) non-participants, we will examine this issue. Physicians willing to refer their patients to a trial may also be different from other physicians. We will therefore compare practice styles regarding diagnosing and prescribing patterns of E-LITE physicians with non-–E-LITE physicians at PAMF.
Funder
Agency for Healthcare Research & Quality
Research Topics
Related Studies
Pilot Project in Applied Artificial Intelligence: Using Machine Learning to Improve the Safety of Hospital Care
Investigator: Sylvia Sudat, PhD
Improving Cancer Care
Investigator: Su-Ying Liang, Ph.D.
Multilevel Study of Lung Cancer Screening Guidelines Implementation (MUST)
Investigator: Jiang Li, Ph.D., MPH
Implementing Universal Lynch Syndrome Screening Across Multiple Healthcare Systems: Identifying Strategies to Facilitate and Maintain Programs in Different Organizations Contexts
Investigators: External PI, Principal Investigator, Su-Ying Liang, Ph.D., Monique de Bruin, M.D., MPH
Severe Mental Illness and Patterns of Emergency Department Utilization
Investigator: Kristen M.J. Azar, R.N., BSN, MSN/MPH
Open and Ask Study
Investigators: Cheryl Stults, Ph.D., Albert S. Chan, M.D., M.S., FAAFP
HOMBRE (Hombres con Opciones para Mejorar el Bienestar y bajar el Riesgo de Enfermedades crónicas)
Investigator: Kristen M.J. Azar, R.N., BSN, MSN/MPH
Advance Care Planning in Older Adults With Multiple Medical Conditions Undergoing High-Risk Surgery
Investigator: External PI, Principal Investigator
Understanding the Needs and Experiences of High Utilizers at the Emergency Department of Highland Hospital
Investigator: Kristen M.J. Azar, R.N., BSN, MSN/MPH
Understanding Non-clinical Determinants of Long-term Hospital Stays Among High Utilizing Patients at ABSMC
Investigator: Kristen M.J. Azar, R.N., BSN, MSN/MPH