Precision in Weighing: A Comparison of Scales Found in Physician Offices, Fitness Centers, and Weight Loss Centers

Objective. Weight assessment is a critical aid in patient care. It is particularly important in monitoring progression of pregnancies, heart failure status, and when adjusting medications. Although weight is generally determined using a scale, few studies have evaluated the precision of non-household scales. The objective of this study was to assess scale precision across a variety of settings. Methods. An evaluation of scales from randomly selected primary care clinics ( n=30), diabetology/endocrinology clinics ( n=7), weight loss facilities ( n=25), and fitness centers ( n=30) was performed. Assessments were completed on a total of 223 scales: 94 from primary care clinics, 32 from diabetology/endocrinology clinics, 39 from weight loss centers, and 58 from fitness centers. Scales were assessed for condition, location in facility, resting surface, commercial designation, and calibration history. Scale precision was validated using 100 lb. (45.5 kg), 150 lb. (68.3 kg), 200 lb. (90.9 kg), and 250 lb. (113.6 kg) certified weights. Results. Overall, scales demonstrated decreased precision with increased weight. At higher weights, more than 15% of scales were off by more than 6 lbs. (2.3 kg), approximately 1 Body Mass Index (BMI) unit. While facility type was not significant, condition, location in facility, resting surface, commercial designation, and calibration history were significant. Conclusions. This study demonstrates that many scales used to measure body weight are imprecise and that scales in health care settings are no more precise than those in other facilities. Clinical decisions based on scales that are imprecise have the potential to cause iatrogenic complications in patient care.

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The Effectiveness of a Healthcare Application and Human Coaching Program in Primary Care Clinics: A Non-randomized Controlled Trial (Preprint)

10.2196/preprints.34531 ◽

2021 ◽

Author(s):

HyoRim Ju ◽

EunKyo Kang ◽

YoungIn Kim ◽

HyunYoung Ko ◽

Belong Cho

Keyword(s):

Primary Care ◽

Weight Loss ◽

Sleep Quality ◽

Chronic Conditions ◽

Chronic Condition ◽

Intervention Group ◽

Self Management ◽

Control Group ◽

Primary Care Clinics ◽

Healthcare Application

BACKGROUND As the global burden of chronic conditions increases, effective management for these are a concern. There is an increasing need for chronic condition management using mobile self-management healthcare applications. OBJECTIVE This study evaluated the effectiveness of a mobile self-management healthcare application combined with human coaching for primary care services in patients with chronic conditions. METHODS A total of 110 patients with hypertension, diabetes, dyslipidemia, and/or metabolic syndrome who visited one of 17 participating primary care clinics from September 2020 to November 2020 were included in this study. Data regarding changes in body weight, sleep conditions, quality of life, depression, anxiety, stress, body mass index, waist circumference, blood sugar levels, blood pressure, and blood lipids levels were recorded. The intervention group (N=65) used a mobile self-management healthcare application with human coaching for 12 weeks, and the control group (N=45) underwent conventional, self-managed health care. RESULTS Patients in the intervention group reported significantly more weight loss than those in the control group (P=.002). The weight loss was markedly greater after using application for nine weeks than using it for four weeks or five to eight weeks (P=.002). Patients in the intervention group reported better sleep quality (P=.04) and duration (P=.004) than those in the control group. CONCLUSIONS The combination of a mobile self-management healthcare application and human coaching in primary care clinics results in better management of chronic conditions. The observed weight loss was greater and sleep quality improved than conventional primary care for patients with at least one chronic condition.

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Palliative Care in a Death-Denying Culture: Exploring Barriers to Timely Palliative Efforts for Heart Failure Patients in the Primary Care Setting

American Journal of Hospice and Palliative Medicine® ◽

10.1177/1049909120920545 ◽

2020 ◽

Vol 38 (1) ◽

pp. 77-83 ◽

Cited By ~ 2

Author(s):

Rebecca M. Crimmins ◽

Lydia Elliott ◽

Darren T. Absher

Keyword(s):

Heart Failure ◽

Primary Care ◽

Palliative Care ◽

Patient Care ◽

Care Setting ◽

Primary Care Setting ◽

Primary Care Providers ◽

Cochrane Library ◽

Care Providers ◽

Communication Time

Context: Heart failure (HF) is a complex, life-limiting disease that is prevalent and burdensome. All major cardiology societies and international clinical practice guidelines recommend the integration of palliative care (PC) interventions alongside usual HF management. Objectives: The purpose of this review of the literature was to evaluate the various barriers to the early initiation of PC for HF patients in the primary care setting. Methods: An integrative literature review was conducted in order to assess and incorporate the diverse sources of literature available. An EBSCO search identified relevant articles in the following databases: Medline complete, Academic Search Premier, CINAHL, PsycINFO, Cochrane Library, and SocINDEX. The search was limited to full text, peer reviewed, English only, and published between 2010 and 2019. Results: Barriers to the integration of PC for HF patients include poor communication between provider/patient and interdisciplinary providers, the misperception and miseducation of what PC is and how it can be incorporated into patient care, the unpredictable disease trajectory of HF, and the limited time allowed for patient care in the primary care setting. Conclusion: The results of this review highlight a lack of communication, time, and knowledge as barriers to delivering PC. Primary care providers caring for patients with HF need to establish an Annual Heart Failure Review to meticulously evaluate symptoms and allow the time for communication involving prognosis, utilize a PC referral screening tool such as the Needs Assessment Tool: Progressive Disease-Heart Failure, and thoroughly understand the benefits and appropriate integration of PC.

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Screening for New Diagnosis of Heart Failure in Primary Care Clinics Using Electronic Health Record and the Impact of Diabetes Mellitus

Journal of Cardiac Failure ◽

10.1016/j.cardfail.2006.06.408 ◽

2006 ◽

Vol 12 (6) ◽

pp. S118

Author(s):

W.H. Wilson Tang ◽

Anil Jain ◽

C. Martin Harris

Keyword(s):

Diabetes Mellitus ◽

Heart Failure ◽

Primary Care ◽

Electronic Health Record ◽

Health Record ◽

Primary Care Clinics ◽

Electronic Health ◽

New Diagnosis ◽

The Impact

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Recruitment of Men Into a Pragmatic Rural Primary Care Weight Loss Trial

American Journal of Men s Health ◽

10.1177/1557988320971917 ◽

2020 ◽

Vol 14 (6) ◽

pp. 155798832097191

Author(s):

Stephanie E. Punt ◽

Daniel L. Kurz ◽

Christie A. Befort

Keyword(s):

Primary Care ◽

Weight Loss ◽

Response Rate ◽

Behavioral Weight Loss ◽

Men And Women ◽

Primary Care Clinics ◽

Rural Primary Care ◽

Lower Response Rate ◽

Enrollment Rates ◽

Mixed Gender

Men remain underrepresented in behavioral weight loss trials and are more difficult to recruit compared to women. We describe recruitment response of men and women into a mixed-gender behavioral weight loss trial conducted within 36 rural primary care clinics. Participants were recruited through primary care clinics via direct mailings ( n = 15,076) and in-clinic referrals by their primary care provider (PCP). Gender differences were examined in response rate to direct mailings, study referral source, and rates of proceeding to study screening, being eligible, and enrolling. Men had a lower response rate to direct mailings than women (7.8% vs. 17.7%, p < .001). Men (vs. women) responding to the mailing were more likely to respond by opt-in postcard (64.6% vs. 56.8%) and less likely to respond by phone (33.9% vs. 39.6%), p = .002. Among potential participants contacting the study ( n = 2413), men were less likely to report being referred by PCPs (15.2% vs. 21.6%; p < .001), but were just as likely to proceed to screening, be eligible, and enroll. Men and women were more likely to proceed to screening when referred by PCPs (93.3% vs. 95.4%) compared to direct mailings (74.2% vs. 73.9%). Enrolled men were older ( p < .001), more likely to be married ( p = .04), and had higher levels of education ( p = .01). Men were less likely than women to respond to direct mailings and to be referred by their PCP, but after contacting the study, had similar screening, eligibility, and enrollment rates. Encouraging and training providers to refer men during clinic visits may help recruit more men into primary care-based weight loss trials.

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Primary Care Clinic Visit Efficiency

International Journal of User-Driven Healthcare ◽

10.4018/ijudh.2015010102 ◽

2015 ◽

Vol 5 (1) ◽

pp. 16-29

Author(s):

Kambiz Farahmand ◽

Satpal Singh Wadhwa ◽

Mahmoud Mostafa ◽

Vahid H Khiabani ◽

Sudhi Upadhyaya

Keyword(s):

Primary Care ◽

Patient Care ◽

Performance Metrics ◽

Primary Care Clinic ◽

Life Time ◽

Coordinated Care ◽

Contact Ratio ◽

Care Clinic ◽

Primary Care Clinics ◽

Veteran's Affairs

A study was done in 2013 regarding Veteran's Affairs primary care clinics in New Mexico. The primary care clinics provide care for a group of patients on regular basis. They also see additional patients as needed. The team consisting of the provider(s), nurse(s), technician(s), and schedulers providing continuous and coordinated care throughout patient's life-time is called Patient Aligned Care Team (PACT). The purpose of the PACT is to maximize patient care using this continuous and familiar care model for the patients. The performance of five out of ten primary care teams were provided using the traditional measures identified by their healthcare system in the Patient Aligned Care Teams Compass Data Definitions. The measurements that were specifically interesting were Ratio of PC Telephone Encounters to All PC Encounters, Ratio of Non-Traditional Encounters, Same Day Appts. w/PC Provider Ratio, Continuity PCP (ER Excluded), Team 2ndDay Post DC Contact Ratio. The data was collected in 2012 and the evaluations, interviews, and analysis was completed in 2013. The team scores was provided and access was obtained to only five out of ten teams which data was available for. The Veteran's Affairs provided data regarding the performance metrics of the PACT teams. The data was evaluated by using statistical correlations. The interview questions were designed to further dissect the performance of each team and their practices. Teams were interviewed and the responses were summarized and analyzed. Responses from each team were converted into team's scores and compared to their PACT performance metrics. The comparison between teams' scores and PACT performance metrics provided insight into each team's perception of its own performance and its PACT performance metrics. The purpose of this project is to identify the value adding and non-value adding activities of the each team. So the management can encourage the promotion of value adding activities, decreasing the variation in the performance of the teams and so maximizing the patient care.

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