Patient cues about weight loss may predict action

A study that analyzed patient responses to brief interventions for weight loss in primary care suggested that patients who said ‘yeah’ or ‘yes’ did not necessary mean the patient would attend such sessions, according to findings recently published in the British Journal of General Practice.

“Although brief interventions have been shown to be successful, [general practitioners] report several barriers to their frequent delivery in primary care consultations, citing limited consultation time as a key restriction,” Charlotte Albury, MSc, doctoral researcher in the Nuffield Department of Primary Care Health Services at the University of Oxford, and colleagues wrote.

“Health care professionals are often unsure whether, and how best, to raise the topic of their patients’ weight, and there is sparse evidence about how [general practitioners] can deliver effective interventions that are acceptable to patients and yet do not take up unnecessary consultation time,” they added.

Albury and colleagues analyzed 226 audio recordings between patients and general practitioners in the U.K. to ascertain how doctors could recognize patients who were likely to attend a weight-management program when offered the chance to participate for free.

Researchers found that positive responses prefaced by “oh” showed an association with a participant attending the free weight management service (OR = 6.27; 95% CI, 1.68-30.48), but those consisting of a stand-alone “yes” showed no conversational evidence that the referral was well received and the participant attended the sessions (OR = 1.2; 95% CI, 0.37-3.95).

The results surprised researchers and suggested that clinicians may sometimes need to ask their patients follow-up questions, Albury said in an interview.

“Responses of ‘yes’ or ‘yeah’ didn’t indicate agreement in consultation or post-consultation action. Although the words sound like patients are agreeing they are actually just indicating information has been received. This doesn’t necessarily mean they’ve accepted, they may require a little more information, so we recommend clinicians check if the patient has any further questions,” she said.

“Responses that sounded enthusiastic — like ‘that sounds great’ — were associated with in-consultation agreement and post-consultation action, but so were responses starting with ‘oh.’ We found this word upgraded responses and showed enthusiastic uptake of referral. Although it is a little word, it did a lot of interactional work to show positivity. But no always meant no,” Albury continued.

Clinicians that responded to the patient cues could save an average of 31 seconds per consultation, adding to the practicality of the findings, she told Healio Family Medicine. – by Janel Miller

Disclosures: Albury reports receiving funding from National Institute for Health Research School for Primary Care Research. Please see the study for all other authors’ relevant financial disclosures.