Improving the Rate of Physician Identification, Diagnosis and Management of Childhood Obesity in the FHC

Kevin Porciuncula, MD

Introduction

Childhood obesity is a growing epidemic in the United States. According to the CDC, approximately 17% of children 2 to 19 years of age are obese.  Primary care physicians are at the forefront of addressing this health crisis. The USPSTF recommends screening children 6 to 18 years of age for obesity and referral of obese children for intensive counseling and behavioral interventions.

Methods

An initial chart review was completed of 295 well-child encounters ages 3-19 between January 2016 and June 2016. Interventions were employed which included quarterly reminders via an electronic newsletter, encouraging the use of template phrases and the creation of a new dot phrase to simplify the referral process. A post-intervention chart review was conducted.

Results

The rate of obesity in the UPMC Shadyside Family Health Center (SFHC) was noted to be 25%. Following intervention, the utilization of a template phrase to document SHAPE-5 education improved from 43% to 72%. Documentation of obesity improved from 46% to 69% and the referral rates improved from 27% to 45%. 

Discussion

We improved the rates of physician identification, diagnosis and management of childhood obesity at the SFHC. The biggest barrier to improvement appeared to be a lack of acknowledgement by parents that this is an important health issue and the lack of time to address this during a well-child visit.

Conclusion

While rates have improved, further work needs to be done to educate our patients and their family about the health risks of obesity.