Shafa, Anousheh

INTRODUCTION: Obesity is associated with endometrial cancer (EC); however, most patients are unaware of this association and the long-term consequences of their elevated body mass index (BMI). Our objectives were to increase both patient awareness of this association and referral rates to our weight loss clinic using quality improvement (QI) methodology. METHODS: A multidisciplinary team used QI methods to create a multi-pronged toolkit to improve obesity education in patients < 80 years old with a BMI ≥30 mg/kg2 and diagnosis of grade 1-2, stage I EC. Gynecologic oncology and bariatric surgery providers, endocrinologists, nutritionists, and psychologists collaboratively implemented the toolkit comprised of provider communication workshops, patient education resources, and dictation templates. A historic cohort from (July through December 2015) was compared to a post-intervention cohort (July through December 2017). Clinical characteristics, documented conversations, and referrals to the weight loss clinic were abstracted. Data for the two cohorts were compared using Chi-squared test, Fisher exact test, and Student t-test. RESULTS: The historic cohort had 54 patients and the post-intervention cohort had 53 patients. Clinical characteristics were balanced between groups. Conversations about obesity increased from 11.1% (6/54) to 79.2% (42/53) after toolkit implementation (P<.001). Referral rates to the weight loss clinic also increased from 3.7% (2/54) to 25.9% (14/53) (P<.005). No clinical characteristics, including age, BMI, or pre-operative diagnosis, were associated with documented conversations or referrals (P=1.0). CONCLUSION: A multidisciplinary quality improvement project can be used to increase discussion about obesity and referral to a weight loss clinic in patients with low-risk EC.