Outpatient evaluation, recognition, and initial management of pediatric overweight and obesity in U.S. military medical treatment facilities
| Autor: | Col. David Carnahan, David R. Arday, Wayne Dickey, Joseph Kelly |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Male
Pediatric Obesity Pediatrics medicine.medical_specialty Percentile Adolescent Overweight Childhood obesity 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Diabetes mellitus Military Facilities Outpatients medicine Humans 030212 general & internal medicine Child General Nursing Medical treatment business.industry Disease Management nutritional and metabolic diseases General Medicine medicine.disease Obesity Child Preschool Workforce Female medicine.symptom business Body mass index Dyslipidemia |
| Zdroj: | Journal of the American Association of Nurse Practitioners. 29:85-93 |
| ISSN: | 2327-6924 |
| DOI: | 10.1002/2327-6924.12398 |
| Popis: | Background and purpose As childhood obesity is a concern in many communities, this study investigated outpatient evaluation and initial management of overweight and obese pediatric patients in U.S. military medical treatment facilities (MTFs). Methods Samples of 579 overweight and 341 obese patients (as determined by body mass index [BMI]) aged 3–17 years were drawn from MTFs. All available FY2011 outpatient records were searched for documentation of BMI assessment, overweight/obesity diagnosis, and counseling. Administrative data for these patients were merged to assess coded diagnostic and counseling rates and receipt of recommended laboratory screenings. Conclusions Generic BMI documentation was high, but BMI percentile assessments were found among fewer than half the patients. Diagnostic recording or recognition totaled 10.9% of overweight and 32.0% of obese. Counseling rates were higher, with 46.4% and 61.0% of overweight and obese patients, respectively, receiving weight related counseling. Among patients 10 years of age or older, rates of recommended lab screenings for diabetes, liver abnormality, and dyslipidemia were not greater than 33%. BMI percentile recording was strongly associated with diagnostic recording, and diagnostic recording was strongly associated with counseling. Implications for practice Improvements to electronic health records or implementation of local procedures to facilitate better diagnostic recording would likely improve adherence to clinical practice guidelines. |
| Databáze: | OpenAIRE |
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