Childhood obesity diagnosis and management remains a challenge despite the use of electronic health records: A retrospective study

Jean-Sébastien Paquette; Laurence Théorêt; Laurence Veilleux; Johann Graham; Marie-Pier Paradis; Nathalie Chamberland; Gabrielle Lanctôt; Pascale Breault; Mathieu Pelletier; Samuel Boudreault

doi:10.1002/hsr2.763

Childhood obesity diagnosis and management remains a challenge despite the use of electronic health records: A retrospective study

Health Sci Rep. 2022 Aug 8;5(5):e763. doi: 10.1002/hsr2.763. eCollection 2022 Sep.

Authors

Jean-Sébastien Paquette^{1

2

3}, Laurence Théorêt^{1

2}, Laurence Veilleux^{1

2}, Johann Graham², Marie-Pier Paradis², Nathalie Chamberland², Gabrielle Lanctôt², Pascale Breault^{1

2}, Mathieu Pelletier^{1

2}, Samuel Boudreault^{1

2}

Affiliations

¹ ARIMED Laboratory, Groupe de Médecine de Famille Universitaire du Nord de Lanaudière, CISSS Lanaudière Joliette Quebec Canada.
² Départment de Médecine Familiale et de Médecine d'urgence, Faculté de Médecine Université Laval Quebec City Quebec Canada.
³ VITAM, Centre de Recherche en Santé Durable Université Laval Quebec City Quebec Canada.

Abstract

Background: The use of electronic health records (EHR) has revolutionized medical practice by improving the quality of care. Childhood obesity (CO) increases the risk of developing other chronic diseases and has a serious psychosocial impact on children. Using EHR may improve this clinical condition since early diagnosis is a crucial means of preventing its negative impacts.

Objectives: The aim of the study was to assess the diagnosis and management of CO in a Canadian academic family medicine group unit (FMG-U) that uses EHR with an integrated CO diagnosis tool.

Methods: This is a retrospective study conducted in an FMG-U in the province of Quebec. The clinical practice guidelines established by the World Health Organization (WHO) were used to assess diagnosis and management of CO. EHR of every patient from 5 to 12 years old who had a medical appointment at the FMG-U in 2017 (n = 618) were analyzed. EHR use by clinicians was assessed by a closed-ended online survey sent to clinicians who provided pediatric care at that clinic in 2017.

Results: We identified 69 patients as obese according to the WHO, of whom 40 had been diagnosed by health professionals at the clinic. Of these, 33 received nutritional counseling; 33 received physical activity counseling; 13 received parent involvement counseling; 19 were referred to another health professional; and 12 were followed up within 6 months. Ten out of 15 clinicians responded to the survey. They all used the EHR integrated CO diagnosis tool but only 20% were truly familiar with it.

Conclusions: This study shows that CO is still underdiagnosed in primary care, notwithstanding the use of EHR with integrated tools. This affects the quality of care. Moreover, even if CO were correctly diagnosed, its management remains incomplete. Knowledge translation by medical organizations plays an important role in addressing this problem.

Keywords: childhood obesity; clinical guidelines; electronic health record; exercise; nutrition; pediatrics.