G430(P) Recognition and response to paediatric obesity in the general outpatient population: are we missing a key opportunity?. (12th March 2018)

• Record Type: Journal Article
• Authors: McClean, AM; Orr, K; Anderson, P; Brown, L; Simpson, J; Holmes, J; O'Connor, B; Anandarajan, M
• Is Part Of: Archives of disease in childhood. Volume 103(2018)Supplement 1
• Page Start: A175
• Page End: A175
• Publication Date: 2018-03-12
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2018-rcpch.419
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Aims: Obesity negatively impacts physical health, mental wellbeing and shortens life expectancy. 1 Reducing childhood obesity rates will save lives. 2 Despite this, children are only routinely screened for obesity twice (4–5 years and 10–11 years) through the National Child Measurement Programme (NCMP). 3 Additional opportunities to identify overweight/obese children cannot be missed. This study aims to explore the prevalence of overweight/obese children in the outpatient population of a district general hospital (DGH) and assess the recognition of these children by paediatricians. Methods: This pilot study began with an audit of growth parameters for 87 children (2–16 years) attending paediatric outpatient/ambulatory clinics during one week in September 2017. Retrospective body mass index (BMI) centile plotting enabled identification of overweight (≥91 st but <98 th centile), obese (≥98 th centile) and severely obese (>99.6 th centile) children. Clinic letters were reviewed to check if children were recognised as overweight/obese during medical consultations. Collaboration with the Public Health Agency (PHA) facilitated comparison with NCMP data. Results: 100% children were weighed but 14% (12/87) had no height documented. BMI centiles were plotted for the remaining 75 children (56%-male, 44%-female). 28% were overweight/obese which compared similarly to NCMP data showing 27% overweight/obese 10–11 year olds in the trust's geographical area. 4 Our study had more obese children at 15% (including 4% severely obese) compared to NCMP data at 6.6%. Only 3 patients had a BMI plotted and consequently diagnosed as obese (all severely obese). 86% of overweight/obese children (presenting with constipation, asthma, enuresis etc) were not actually recognised as overweight/obese during the consultation. Conclusions: Our paediatric outpatient population has an alarmingly high prevalence of obese/overweight children, yet this problem is poorly recognised. Subsequent questionnaires indicated strong staff support for height/weight/BMI centile plotting for every child to improve obesity detection. Therefore, universal BMI plotting (utilising the RCPCH growth app) is being implemented as a quality improvement drive. Telephone information-gathering exercises revealed fellow DGHs reporting similar challenges with paediatric obesity recognition. Our pilot has grown into a regional obesity awareness project. We are collaborating with dieticians, physiotherapists and the PHA to create a multicentre, multidisciplinary paediatric obesity awareness e-learning package for staff. References: . Cabinet Office, Department of Health, HM Treasury, and Prime Minister's Office. Childhood obesity: A plan for action. https://www.gov.uk/government/publications/childhood-obesity-a-plan-for-action (Accessed: 17 October 2017). . Public Health Agency, Northern Ireland. Tackling childhood obesity . http://www.publichealth.hscni.net/directorate-public-health/health-and-social-wellbeing-improvement/tackling-childhood-obesity (Accessed: 17 October 2017). . Public Health England. National child measurement programme . https://www.gov.uk/government/collections/national-child-measurement-programme (Accessed: 17 October 2017). . Northern Ireland Statistics and Research Agency. Overweight and Obese Children by Trust area- 2012. http://www.ninis2.nisra.gov.uk/public/PivotGrid.aspx?ds=8209&lh=73&yn=2010-2012&sk=134&sn=Health+and+Social+Care (Accessed: 17 October 2017).