Inpatient Referral to Comprehensive Weight Management for Patients With Obesity

Study Overview
=================
Brief Summary
-----------------
Hospitalized patients with obesity who are not already in CWM (comprehensive weight management), or not comfort care/hospice will be identified by the hospitalists then the study dietitian will consent for the patient for enrollment (and answer any question regarding diet/lifestyle) in the study. The intervention will be a CWM referral at discharge. The outcome will be what percentage of these patients go to the CWM clinic at 6 months. At 6 months, the investigators will also call each participant to get a qualitative idea of the process of inpatient referral and barriers to the CWM clinic visit. Weight loss, starting on anti-obesity medication, bariatric surgery will be assessed as a secondary outcome.

Detailed Description
-----------------
The investigators will conduct an uncontrolled, one arm interventional study on Adult (≥ 18 years of age) hospitalized patients who have obesity (BMI ≥ 30 kg/m 2 or BMI ≥ 27 kg/m 2 if Asian/South Asian), and after stabilization of their acute medical conditions. Prior to hospital discharge, patients will receive a referral for an outpatient comprehensive weight management clinic, with a message that will be sent to the CWM clinic scheduler. Then the investigators will follow the patients forward for 6 months from hospital discharge to assess primary and secondary outcomes. Also, the investigators will look at a historical control group of hospitalized patients with obesity (age, comorbidity matched) from 2014-2019 (chosen instead of 2020, to avoid any impact of 2020 COVID 19 pandemic) and compare the primary and secondary outcomes. At six months after discharge, patients will receive a phone call from the investigators to ascertain whether they were able to go to the comprehensive weight management clinic and about their experience. Hospitalized patients who have decision-making capacity and whose acute medical condition has been stabilized who meet study criteria will be identified by study physician(s) who will look at his/her personal patient list on a regular basis to identify patients who meet enrollment criteria and will refer the patients to the co-investigator who is not directly involved in the patient's care who will then discuss enrollment with patients.

Official Title
-----------------
Inpatient Referral to Comprehensive Weight Management for Patients With Obesity

Conditions
-----------------
Obesity

Intervention / Treatment
-----------------
* Other: referral to comprehensive weight management clinic


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Adult (≥ 18 years of age) hospitalized patients who have obesity (BMI ≥ 30 kg/m2 or BMI ≥ 25 kg/m2 if Asian/South Asian) Who have decision-making capacity Whose acute medical condition has been stabilized. Exclusion Criteria: Patients in the ICU or requiring > 6 LPM of supplemental oxygen Patients enrolling in hospice/comfort care Patients who are already enrolled in weight management or have undergone previous metabolic / bariatric surgery. Non-English speaking patients. Pregnant patients

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Intervention Arm<br>-Adult (≥ 18 years of age) hospitalized patients who have obesity (BMI ≥ 30 kg/m2 or BMI ≥ 27 kg/m2 if Asian/South Asian), as recorded in the medical chart, who have decision-making capacity and whose acute medical condition has been stabilized. we will exclude patients who are enrolling in hospice/comfort care and the patients who are already enrolled in the CWM clinic. Non-English speaking patients. Patients who have opted out of research in their Epic EHR will be excluded from consideration for participation. | Other: referral to comprehensive weight management clinic<br>* Patients will receive a referral for outpatient CWM clinic, with a message sent to the CWM clinic scheduler, prior to hospital discharge. At six months after discharge, the patient will receive a phone call from the investigators to ascertain whether they were able to go to the CWM clinic and about their experience.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Perform a feasibility study of providing referral to outpatient comprehensive weight management clinic to Inpatients with obesity. | Percentage of patients who are seen in weight management clinic at 6 months from hospital discharge | Six months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The number of Comprehensive weight managment clinic visits at 6 months. |  | six month and 12 month | 
| Weight loss at 6 months from hospital discharge. |  | six month and 12 month | 
| Qualitative information about the experience of getting referral for outpatient weight management while inpatient and experience of going to weight management | Obtained by survey and phone call | six month and 12 month | 
| Percentage of patients receiving weight-loss medications or being referred for bariatric surgery. |  | six month and 12 month | 
| Compare primary and secondary outcomes with a historical control of patients with obesity | Historical control will be defined as inpatients with obesity admitted to the same hospital from 2014 to 2019 | six month and 12 month |