Shared decision-making underutilisation at an outpatient clinic during BMI monitoring in rural Uganda

Introduction
Recall of medical instructions is associated with improved adherence to treatment. The recall of the Body Mass Index (BMI) is important for the improvement of adherence to treatments related to obesity. The burden of obesity all over the world has increased, including in many sub-Saharan African countries.
Objectives
This study measured the recall of BMI, shared decision-making (SDM), and patients’ demographics to determine if they were associated.
Methods
The study was conducted at a rural hospital outpatient clinic in South Western Uganda. Data were collected using a questionnaire and collaboRate-5 tool for measuring shared decision-making. Data were analysed using SPSS version 20. The chi-square test and Pearson coefficient test were done.
Results
Out of the 92 participants in this study, the median age was 36 years, in an age range of 18 to 87 years, the majority were male 54 (58.7%), most had a background of attending formal education 75 (81.5%), 79 (85.9%) were not able to recall their BMI; 13 (14.1%) were able to recall their BMI. Only gender among demographic factors studied was associated with recall of BMI (p = 0.027). Shared decision-making was associated with the recall of BMI (P < 0.001).
Conclusion
The proportion of patients who were not able to recall their BMI after the outpatient clinic visit was high. Gender and the use of SDM were associated with recall of BMI. Measured items describing the use of SDM were only reported among 21(22.8%) participants. SDM was underutilised during the study period at the outpatient clinic. There is a need to have continuous medical education on SDM.

引言
医疗医嘱记忆与治疗依从性提升密切相关。而体重指数（Body Mass Index, BMI）记忆对于改善肥胖相关治疗的依从性具有重要意义。当前全球肥胖负担呈上升趋势，诸多撒哈拉以南非洲国家亦未能幸免。

研究目的
本研究旨在评估受试者的BMI记忆情况、共同决策（Shared Decision-Making, SDM）水平以及患者人口统计学特征，以明确上述因素间是否存在关联。

研究方法
本研究于乌干达西南部某乡村医院门诊诊所开展。研究数据通过问卷以及用于评估共同决策水平的collaboRate-5工具采集完成，随后采用SPSS 20.0统计软件进行数据分析，分析方法涵盖卡方检验与皮尔逊相关系数检验。

研究结果
本研究共纳入92名受试者，年龄中位数为36岁，年龄跨度为18~87岁；其中男性54例（58.7%），占比最高；75例（81.5%）受试者接受过正规教育；79例（85.9%）无法回忆起自身BMI值，仅13例（14.1%）可准确回忆。在本次研究涉及的人口统计学因素中，仅性别与BMI记忆存在显著关联（p=0.027）。共同决策水平与BMI记忆呈显著相关（P<0.001）。

结论
门诊就诊后无法回忆自身BMI值的患者占比颇高。性别与共同决策的应用情况均与BMI记忆显著相关。本次研究中，仅21例（22.8%）受试者报告了共同决策相关测评条目完成情况。研究期间，该门诊诊所的共同决策应用率偏低，亟需开展针对共同决策的持续性医学教育培训。