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Documentation of weight management practices for individuals with spinal cord injuries and disorders.

Locatelli SM, LaVela SL. Documentation of weight management practices for individuals with spinal cord injuries and disorders. Spinal Cord. 2016 Dec 1; 54(12):1176-1182.

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STUDY DESIGN: This cross-sectional chart review study included 100 US Veterans with spinal cord injuries/disorders (SCI/D) who received care at a Veterans Affairs (VA) SCI facility during a 12-month period. Progress notes were examined to extract need for weight management (WM), patient-provider discussions about risk due to overweight/obesity, recommended lifestyle changes and/or follow-up and WM education. OBJECTIVES: To understand what WM services are offered to Veterans with SCI/D within the VA SCI System of Care during comprehensive preventive health evaluations (annual evaluations), inpatient stays and outpatient visits. SETTING: VA SCI System of Care, Department of Veterans Affairs, United States. RESULTS: Overall, 73% demonstrated a need for WM. Weight was most frequently addressed during the nutrition assessment of annual evaluations, but this assessment was most likely to be skipped. Nutrition histories were missing many key components. Over half received WM education; individuals who were described as overweight/obese by their provider were more likely to receive education. Most of the Veterans who were seen in an inpatient setting were weighed; weight was only discussed with 12%. Less than half of the Veterans with outpatient visits were weighed, and 23% received WM recommendations. CONCLUSIONS: Weight was frequently discussed during nutrition assessments, but infrequently addressed during outpatient or inpatient encounters. Few Veterans received specific recommendations on caloric/nutrient requirements and nutrition histories were missing recommended elements. Additional work is needed to help providers to incorporate WM information into care.

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