EMR Clinical Reminders Don't Improve Weight Loss in Obese Patients

Though automated clinical reminders sent to physicians have produced notable results in diabetes management, a Mayo Clinic study found they do not improve weight loss in overweight and obese patients.

Over the past few years, the US Department of Health and Human Services (HHS) has attempted to heighten awareness of potential meaningful uses for electronic medical records (EMR).

Among the areas stressed are automated clinical reminders, which have been shown to improve breast cancer, abdominal aortic aneurysm, and osteoporosis preventive screening rates. In addition, EMR reminders have produced notable results when used to contact diabetes patients regarding cholesterol and HgA1c levels.

Mayo Clinic researchers recently hypothesized that prompting physicians to recommend lifestyle changes to patients with a body mass index (BMI) above 25 kg/m2 would lead to a greater decrease in BMI over 3-6 months, as compared to patients whose physicians did not receive such automated alerts.

Study participants included 659 patients whose physicians were prompted to counsel on lifestyle changes and 634 patients who received usual care. All patients were seen by a physician between January 2009 and April 2009 or January 2010 and April 2010 and had repeat visits between July 2009 and October 2009 or July 2010 and October 2010. Patients who were seen in 2009 represented the historic control group, while those seen in 2010 served as the treatment group.

However, clinical reminders sent to physicians did not improve weight loss in overweight and obese patients. According to the authors, those study results “reinforce the widely held notion that the effective management of obesity remains difficult and requires a multidisciplinary approach.”

The researchers suggested that the proven benefits of automated clinical reminders in other diseases do not translate to obesity because the prompts cannot address the root causes of the problem. The authors also indicated that the number of electronic prompts has increased, so physicians may have “alert fatigue.” Additionally, short appointment times — averaging 16 minutes in the United States —may preclude adequate discussion of lifestyle changes.