Applying practice recommendations for the prevention and treatment of obesity in children and adolescents.
To describe pediatric clinicians' adherence to practice recommendations for obesity prevention and treatment, we conducted a cross-sectional analysis of 227 medical records of 3- to 18-year-old patients (seen from September 2003 to April 2004) and a longitudinal analysis of data from 632 overweight and obese patients (followed through March 2006). The cross-sectional analysis showed that early practice adopters (n = 3) more frequently recorded BMI (91% of patients), a diagnosis (89%), and counseling (82%) compared with late adopters (n = 9; 34%, 51%, and 48% of patients, respectively; P < .001). The longitudinal analysis showed that among overweight and obese patients, documentation of BMI dropped from 96% at the first clinic visit to 27% by the fifth visit; documentation of individual risk behaviors fell from >or=72% at the first visit to <or=23% at the fifth visit. Despite initial adoption of screening and assessment practices, clinicians' attention to weight management diminished over time.
Dorsey
Karen B
KB
Yale University School of Medicine, New Haven, CT 06520-8064, USA. Karen.Dorsey@yale.edu
Mauldon
Maria
M
Magraw
Ruth
R
Valka
Julie
J
Yu
Sunkyung
S
Krumholz
Harlan M
HM
D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D037001:Directive Counseling; D019983:Guideline Adherence; D006801:Humans; D008137:Longitudinal Studies; D009765:Obesity / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D012307:Risk Factors; D015431:Weight Loss