Education for providers on weight management

Learning about providing weight management

• Access CU eLearning modules on obesity management
  Get updated on evidence-based weight loss and maintenance treatments and overcome common patient communications issues around addressing weight as a health concern.  Examples of patient scenarios and treatment, including in-visit scripting.
  
  Earn up to 2 CME credits for completion.
  Register at https://CUeLearning.org
• Click on "My Account" and then "OTHER" and select "PATHWEIGH"
  • If you have any questions you may contact Support@cuelearning.org.
  • If you need an access code please email PATHWEIGH@CUAnschutz.edu or Johnny.Williams@CUAnschutz.edu

   

• Access training from the World Obesity Federation
  • Additional training is available through the World Obesity Federation’s SCOPE curriculum SCOPE | World Obesity Federation. There are 8 modules covering the breadth of weight management that are also eligible for CME credit. Please contact Johnny.williams@CUAnschutz.edu for an access code. 

• UpToDate is available on the provider interface in EPIC                                                                                                    
  • The obesity section includes the following chapters that can be accessed before, during or after a weight-prioritized visit.
    • Obesity in adults: Etiology and risk factors
    • Obesity in adults: Determining body composition in adults
    • Obesity in adults: Health consequences
    • Obesity in adults: Dietary therapy
    • Obesity in adults: The role of physical activity and exercise
    • Obesity in adults: Drug therapy
    • Obesity in adults: Behavioral therapy
    • Bariatric and metabolic surgery
    • Beyond the basics: Patient education on losing weight (*can be printed as a handout for patients)

• Access the clinician and staff PATHWEIGH Training
  Learn how to use the PATHWEIGH workflow and disappearing help text available in Epic. Find directions on using the e-consult service in Epic to request a consultation on patients with complex presentations. PATHWEIGH introduction video

• Access information from our prior learning communities 
  PATHWEIGH Learning Communities are collaborative meetings that are held to share best practices related to weight management. These 45-minute meetings are held via Zoom to go over materials that are relevant to weight-prioritized visits. Staff from both UC Health and CU Medicine Clinics that offer Weight Prioritized Visits are welcome to attend. 

Conducting weight management

Visit flow: 

• Once you are in a patient encounter, wrench in the disappearing help text by creating a speed button or use the weight management smartset to guide the visit discussion and treatment plan
• If using the disappearing help text, position the cursor in the HPI section of your note and click on the WPVNOTE speed button to import the patient's answers to their weight history. If using the weight management smart set, click 'edit' to import the patient's answers
• Specifically, clinicians should consider a discussion of
  • lifestyle change for patients with BMI≥25 kg/m²,
  • anti-obesity medication at BMI≥30 kg/m² (or BMI≥27 kg/m² with weight-related comorbidities) and
  • bariatric surgery for BMI≥40 kg/m² (or BMI≥35 kg/m² with weight-related comorbidities).
• Patients especially with mental health issues, binge-eating disorder, or past trauma associated with weight may be referred to in-practice or local behavioral health support. Other patients with challenges in making and sustaining behavior changes may also be referred.
• All tools described above are optional or can be used in part.
• Encourage patients to return for a weight-prioritized follow-up visit
• E-consults are available through endocrinology PATHWEIGH eConsult Order

Links to coupons and prior authorization strategies for anti-obesity meds

1. GoodRx app or website can be used to find commonly used medications at a lower cost to the patient – phentermine, topiramate, naltrexone, and bupropion.
2. Saxenda (Liraglutide) and Wegovy (Semaglutide) – often requires the trial of ≥ 1 weight loss medication in addition to lifestyle changes (diet and exercise).  Documentation of past trials and attempted lifestyle changes will support the approval of Wegovy.
3. Coupons and Copay Cards:
   1. Qsymia (Phentermine and topiramate extended-release) - https://qsymiaengage.com
   2. Contrave (Bupropion and naltrexone) - https://contrave.com/enrollment/
   3. Plenity - https://www.myplenity.com
4. Your assigned UCHealth pharmacist can help!

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