(P055) INTEGRATING THE 2020 CANADIAN ADULT OBESITY CLINICAL PRACTICE GUIDELINES INTO A CARDIOVASCULAR REHABILITATION SETTING

Background: Over 7 million Canadians are living with obesity and about 2.6 million Canadians are living with heart disease. Many individuals living with obesity are at higher risk of developing cardiovascular diseases over their lifetime, requiring cardiac care, including cardiovascular rehabilitation (CR). The 2020 Canadian Adult Obesity Clinical Practice Guidelines (CPGs) recommends health care providers (HCPs) utilize the 5As Framework for Obesity Management™ (ASK, ASSESS, ADVISE, AGREE, ASSIST) in adults to offer a safe, non-judgemental space to discuss their weight. A pilot project integrating the 5As was established within a CR setting of a tertiary cardiac care institution.

METHODS AND RESULTS: As part of a larger initiative to implement the CPGs within a tertiary cardiac care institution, an interdisciplinary committee (including patient advocates, clinicians, students, management, and external experts) identified both knowledge gaps as well as opportunities to improve patient-care delivery within a CR setting. A multidisciplinary sub-committee developed a pilot project implementing 3 of the 5As: ASK for permission to discuss weight and explore readiness; AGREE on health outcomes, sustainable behavioural goals, and realistic expectations; and ASSIST in accessing appropriate resources and provider-referrals. The CR setting did not have appropriate resources to include 2 of the 5As: ASSESS (assess adiposity-related complications and “root causes” of weight gain) or ADVISE (advise on health risks and [all available] treatment options). The pilot focused on developing a standardized question and determining the appropriate timing for asking the question. For a trial period of 1 month, 3 clinicians systematically asked all patients during a CR assessment if they wanted to discuss their weight. Patients identifying that weight was a concern were provided with a newly created education booklet on weight-bias/stigma, factors affecting body weight, evidence-based treatments and resources for support (generated through work of an additional sub-committee). During the 1-month trial, 42 patients were asked the standardized question, with 15 (35.7%) answering yes. Patients replying “yes” received the education booklet, "Myths about Obesity: Why it’s not about weight". Clinician feedback about the patients’ reception to the question and the education resource was also collected using a qualitative approach.

Conclusion: HCPs within a CR setting are utilizing 3 of the 5As Framework for Obesity Management™ by systematically asking patients if they would like to discuss their weight. Next steps will focus on obtaining evaluation feedback from patients in this pilot project, to adjust and improve delivery of care that is consistent with the updated obesity CPGs.