Effects of Education and Experience on Primary Care Providers’ Perspectives of Obesity Treatments during a Pragmatic Trial

OBJECTIVE: To examine the impact of a one-year pragmatic obesity trial on primary care providers’ (PCPs) perspectives of treatment. METHODS: PCPs from four intervention (PCP-I) and five control clinics (PCP-C) completed pre- and post-intervention surveys on weight loss counseling, comfort discussing obesity treatments and perceived effectiveness of interventions; questions were rated on 0–10 Likert scales. Only PCP-I received patient updates and education about obesity management. RESULTS: Eighty PCPs completed pre-intervention surveys [pre] (71% female, 71% physicians); 82 PCPs completed post-intervention surveys [post] (66% female, 70% physicians). PCPs were most comfortable discussing exercise (median 8, interquartile range 7–9), even after the trial (P=0.71). PCPs were least comfortable discussing phentermine/topiramate ER (4, 2–6), but developed more comfort (pre 3, 1.5–6; post 5, 3–7; P<0.001). Only PCP-I became more comfortable discussing phentermine (pre 7, 4–8; post 8, 7–9; P=0.026). After the trial, PCPs rated phentermine/topiramate ER more effective (pre 5, 3–6; post 7, 5–8; P<0.001); only PCP-I rated exercise less effective (pre 7, 4–8.5; post 5, 3–7; P=0.035) and phentermine more effective (pre 5, 5–7; post 7, 6–8; P<0.001). CONCLUSIONS: PCPs initially overvalued exercise and undervalued medications. PCPs exposed to education and experience gave higher comfort and effectiveness ratings to weight loss medications.