PT - JOURNAL ARTICLE AU - Perreault, Leigh AU - Suresh, Krithika AU - Rodriguez, Carlos AU - Dickinson, L. Miriam AU - Willems, Emileigh AU - Smith, Peter C. AU - Williams, Johnny AU - Gritz, R. Mark AU - Holtrop, Jodi Summers TI - Baseline Characteristics of PATHWEIGH: A Stepped-Wedge Cluster Randomized Study for Weight Management in Primary Care AID - 10.1370/afm.2966 DP - 2023 May 01 TA - The Annals of Family Medicine PG - 249--255 VI - 21 IP - 3 4099 - http://www.annfammed.org/content/21/3/249.short 4100 - http://www.annfammed.org/content/21/3/249.full SO - Ann Fam Med2023 May 01; 21 AB - PURPOSE To describe the characteristics of patients and practice of clinicians during standard-of-care for weight management in a large, multiclinic health system before the implementation of PATHWEIGH, a pragmatic weight management intervention.METHODS We analyzed baseline characteristics of patients, clinicians, and clinics during standard-of-care for weight management before the implementation of PATHWEIGH, which will be evaluated for effectiveness and implementation in primary care using an effectiveness-implementation hybrid type-1 cluster randomized stepped-wedge clinical trial design. A total of 57 primary care clinics were enrolled and randomized to 3 sequences. Patients included in the analysis met the eligibility requirements of age ≥18 years and body mass index (BMI) ≥25 kg/m2 and had a weight-prioritized visit (defined a priori) during the period March 17, 2020 to March 16, 2021.RESULTS A total of 12% of patients aged ≥18 years and with a BMI ≥25 kg/m2 seen in the 57 practices during the baseline period (n = 20,383) had a weight-prioritized visit. The 3 randomization sequences of 20, 18, and 19 sites were similar, with an overall mean patient age of 52 (SD 16) years, 58% women, 76% non-Hispanic White patients, 64% with commercial insurance, and with a mean BMI of 37 (SD 7) kg/m2. Documented referral for anything weight related was low (<6%), and 334 prescriptions of an antiobesity drug were noted.CONCLUSIONS Of patients aged ≥18 years and with a BMI ≥25 kg/m2 in a large health system, 12% had a weight-prioritized visit during the baseline period. Despite most patients being commercially insured, referral to any weight-related service or prescription of antiobesity drug was uncommon. These results fortify the rationale for trying to improve weight management in primary care.