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Role of the family doctor in the management of adults with obesity: a scoping review
  1. Elizabeth A Sturgiss1,
  2. Nicholas Elmitt1,
  3. Emily Haelser1,2,3,
  4. Chris van Weel4,5,
  5. Kirsty A Douglas1
  1. 1 Academic Unit of General Practice, Australian Nation University Medical School, Canberra, Australia
  2. 2 School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia
  3. 3 School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
  4. 4 Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, Netherlands
  5. 5 Department of Health Services Research and Policy, Australian National University, Canberra, Australia
  1. Correspondence to Dr Elizabeth A Sturgiss; elizabeth.sturgiss{at}anu.edu.au

Abstract

Objectives Obesity management is an important issue for the international primary care community. This scoping review examines the literature describing the role of the family doctor in managing adults with obesity. The methods were prospectively published and followed Joanna Briggs Institute methodology.

Setting Primary care. Adult patients.

Included papers Peer-reviewed and grey literature with the keywords obesity, primary care and family doctors. All literature published up to September 2015. 3294 non-duplicate papers were identified and 225 articles included after full-text review.

Primary and secondary outcome measures Data were extracted on the family doctors’ involvement in different aspects of management, and whether whole person and person-centred care were explicitly mentioned.

Results 110 papers described interventions in primary care and family doctors were always involved in diagnosing obesity and often in recruitment of participants. A clear description of the provider involved in an intervention was often lacking. It was difficult to determine if interventions took account of whole person and person-centredness. Most opinion papers and clinical overviews described an extensive role for the family doctor in management; in contrast, research on current practices depicted obesity as undermanaged by family doctors. International guidelines varied in their description of the role of the family doctor with a more extensive role suggested by guidelines from family medicine organisations.

Conclusions There is a disconnect between how family doctors are involved in primary care interventions, the message in clinical overviews and opinion papers, and observed current practice of family doctors. The role of family doctors in international guidelines for obesity may reflect the strength of primary care in the originating health system. Reporting of primary care interventions could be improved by enhanced descriptions of the providers involved and explanation of how the pillars of primary care are used in intervention development.

  • preventive medicine
  • primary care

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Twitter @LizSturgiss

  • Contributors EAS, NE, EH, CvW and KAD were part of the development and publication of the protocol. EAS and NE were involved in the search and data extraction. EH was the third author to check the data extraction tool. EAS and NE did the initial analysis and synthesis. EAS and NE presented the findings of the scoping review at the stakeholder sessions. EAS wrote the first draft of the manuscript. EAS, NE, EH, CvW and KAD then contributed to the writing of the manuscript and approved the final version.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Further data about the studies that were excluded from the scoping review are available by request from the authors. All data regarding included studies are included in this paper and no additional data on these studies are available.

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