Research News

The Cleveland Clinic has been approved for funding from the Patient-Centered Outcomes Research Institute (PCORI) to implement a lifestyle intervention obesity treatment model across all Cleveland Clinic Northeast Ohio primary care practices.

Obesity is an increasingly common condition throughout the United States. Two-in-five adults are considered to have obesity, which increases risk of developing serious health complications including cardiovascular disease, kidney disease and Type 2 diabetes. Obesity has recently been recognized as a chronic disease by the medical community. However, obesity treatment programs that have been developed throughout the Cleveland Clinic have not been consistently implemented across all primary care practices in Northeast Ohio.

The $1.5 million project, led by Anita Misra-Hebert, MD, MPH, director of Cleveland Clinic’s Healthcare Delivery and Implementation Science Center, along with co-principal investigator Marcio Griebeler, MD, director of the Diabesity Center and Obesity Initiatives within Cleveland Clinic’s Endocrinology department, will significantly expand current health system obesity treatment resources and build on the shared medical appointments (SMAs) model, where multidisciplinary teams deliver obesity treatment interventions.

Cleveland Clinic is part of PCORI’s Health Systems Implementation Initiative (HSII), which connects selected health systems across the U.S. to reduce the time needed to bring a research discovery to patient care. Cleveland Clinic launched its own Healthcare Delivery & Implementation Science Center in 2019, initiated by Tom Mihaljevic, MD, CEO, President and Morton L. Mandel CEO Chair of Cleveland Clinic. Dr. Misra-Hebert is co-lead on programs through the Health Systems Implementation Initiative with Beri Ridgeway, MD, Cleveland Clinic’s Chief of Staff.

“We were excited when the PCORI HSII program offered an opportunity to propose an implementation project based upon prior PCORI-funded research addressing obesity,” Dr. Misra-Hebert says. “We had already prioritized improving obesity care in our health system in several ways and this project will help to move that goal forward.”

To encourage maximum patient participation, Dr. Misra-Hebert’s team will be distributing educational materials regarding obesity management to all primary care providers, presenting at primary care staff meetings on intensive lifestyle obesity treatment and urging staff to make the diagnosis of obesity in all patients with BMI >30.

Obesity is a complicated disease with a wide variety of causes and potential solutions unique to each patient. It’s imperative that the program includes practitioners from multiple relevant disciplines to provide the patient with the greatest opportunity for success, Dr. Misra-Hebert says.

The program will include a centralized pool of practitioners from various disciplines including primary care providers, endocrinology providers, and providers from the Wellness Medicine program. This group of clinicians will conduct initial individual appointments for patient evaluation and then subsequently refer the patient to the appropriate SMA program. The SMA programs will also include the involvement of a multidisciplinary group of providers including psychologists, dieticians and exercise physiologists. Additional providers including social workers and weight management health coaches will have roles in components of the implementation project.

Dr. Misra-Hebert hopes this new program will have a long-term impact in reducing comorbidities and cardiovascular risk in the communities Cleveland Clinic serves.

“Focusing on widespread implementation of successful models of care is critical to ensuring patients across our health system are receiving the best care possible,” Dr. Misra-Hebert says. “We’re thankful for PCORI’s support in addressing a health condition that can have significant long-term impact on a patient’s life.”