Pediatric obesity management: variation by specialty and awareness of guidelines.
A survey of 2727 pediatric clinicians evaluated pediatric overweight management and awareness of Expert Committee recommendations (ECR) on obesity. Adjusted response rate was 45%. ECR awareness was reported by 24.6%. Family practice specialists (FPS) were less likely than pediatric specialists (PS) to be aware of ECR (OR, 0.46; 95% CI, 0.30-0.71). Body mass index (BMI) was never used by 25.6% to identify overweight; 35.4% did not obtain laboratory tests. Among PS but not FPS, ECR awareness was associated with BMI use (OR, 2.70; 95% CI, 1.56-4.65) and frequent follow-up (OR, 2.48; 95% CI, 1.58-3.90). FPS were more likely than PS to use BMI (OR, 1.78; 95% CI, 1.15-2.75) and obtain thyroid function tests (OR, 2.58; 95% CI, 1.53-4.37), but less likely to obtain fasting lipids (OR, 0.47; 95% CI, 0.30-0.73). Specialty differences in dietary recommendations, referrals, and barriers to treatment were identified. Pediatric overweight management guidelines should consider specialty differences and be accessible to all pediatric care providers.
Rhodes
Erinn T
ET
Division of Endocrinology, Children's Hospital Boston, Boston, Massachusetts 02115, USA. erinn.rhodes@childrens.harvard.edu
Ebbeling
Cara B
CB
Meyers
Alan F
AF
Bayerl
Cynthia T
CT
Ooi
Wee L
WL
Bettencourt
Maria F
MF
Ludwig
David S
DS
D015992:Body Mass Index; D005194:Family Practice; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D009722:Nurse Practitioners; D050177:Overweight; D010372:Pediatrics; D017410:Practice Guidelines as Topic; D011320:Primary Health Care