Impact of electronic medical record utilization on obesity screening and intervention for obese patients with endometrial cancer

Objective: To identify the prevalence of obesity documented within the electronic medical record problem list.

Methods: We conducted a retrospective cohort study of adult patients with obesity and endometrial cancer receiving care from January 2018 to March 2021 at a single institution. Obesity intervention was defined as receipt of at least one of the following: referral to weight loss clinic, referral to a nutritionist, completion of obesity intervention tab, or documentation of weight loss counseling. Our secondary objectives were to (1) identify the prevalence of completed obesity interventions, (2) identify the number of patients who have achieved weight loss since their initial visit, and (3) identify covariates associated with presence of obesity on problem list, completion of obesity interventions, and weight loss.

Results: We identified 372 patients who met inclusion criteria. Of eligible patients, 202 (54%) had obesity documented on their problem list and 171 (46%) completed at least one obesity intervention. Within our cohort, 195 (52%) patients achieved weight loss from diagnosis or initial clinical encounter at our institution to most recent clinical encounter with median weight loss of 3.9 kg (IQR 1.5-8.0). In the multivariable logistic regressions, patients with obesity on the problem list were approximately twice as likely to have completion of obesity intervention (OR 1.91, 95% CI 1.09, 3.35, p=0.024). Although presence of obesity on the problem list was not associated with weight loss, completion of health maintenance obesity intervention tab in the electronic medical record (Epic) was associated with weight loss (OR 2.77, 95% CI 1.11, 6.89, p=0.03).

Conclusions: Only half of obese endometrial cancer patients had documentation of obesity within the electronic medical record problem list. The electronic medical record could be leveraged to achieve compliance with weight loss interventions. Further investigation on how the electronic medical record can be optimized to help patients achieve weight loss is needed.