Adult obesity prevalence in primary care users: An exploration using Canadian Primary Care Sentinel Surveillance Network (CPCSSN) data

Rigobon, Alanna; Birtwhistle, Richard; Khan, Shahriar; Barber, David; Biro, Suzanne; Morkem, Rachael; Janssen, Ian; Williamson, Tyler

doi:10.17269/cjph.106.4508

Cited by 21 publications

(19 citation statements)

References 14 publications

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“…[27][28][29] Missing measurements for length, height and weight and data standardization are variable across clinics and EMRs, as well as within the same EMR. 30,31 Our study population was limited to patients who visit their primary care providers. In a study investigating the representativeness of patients in CPCSSN, network patients were reasonably representative of patients in Canadian primary care practices and only somewhat representative of the Canadian general population.…”

Section: Limitationsmentioning

confidence: 99%

Prevalence of toddler, child and adolescent overweight and obesity derived from primary care electronic medical records: an observational study

Biro¹,

Barber

Williamson

et al. 2016

CMAJ Open

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Section: Limitationsmentioning

confidence: 99%

Prevalence of toddler, child and adolescent overweight and obesity derived from primary care electronic medical records: an observational study

Biro¹,

Barber

Williamson

et al. 2016

CMAJ Open

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“…For this study, we used Canadian Primary Care Sentinel Surveillance Network (CPCSSN), a large pan-Canadian primary care database that combines de-identified patients' electronic medical records (EMRs) data from 12 primary care practicebased research networks across Canada, spanning 8 provinces and 1 territory (15,26,27). CPCSSN extracts primary care data on a regular (quarterly) basis from different EMR products and transforms it into a common database in a central source (26,27).…”

Section: Data Source and Study Populationmentioning

confidence: 99%

“…CPCSSN extracts primary care data on a regular (quarterly) basis from different EMR products and transforms it into a common database in a central source (26,27). By May 2016, nearly 1200 sentinels from over 200 practice sites participated in CPCSSN; the database included demographics, encounter diagnoses, lab results, referrals, procedures, and prescriptions for more than 1.5 million patients (15). To address problems that may arise from EMR-data related issues, such as unstandardized data entry and free-text documentation, CPCSSN applies extensive cleaning algorithms (26).…”

Section: Data Source and Study Populationmentioning

confidence: 99%

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Evaluating Prevalence and Patterns of Prescribing Medications for Depression for Patients With Obesity Using Large Primary Care Data (Canadian Primary Care Sentinel Surveillance Network)

et al. 2020

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Introduction: Depression is a serious disorder that brings a tremendous health and economic burden. Many antidepressants (AD) have obesogenic effects, increasing the population of obese patients at increased risk for a more severe disease course and poor treatment response. In addition, obese patients with depression may not be receiving the recommended standard of care due to "obesity bias." It is important to evaluate prescribing pharmacological treatment of depression in patients with obesity. Objectives: To describe the prevalence and patterns of AD prescribing for patients with depression and comorbid obesity compared with normal weight patients, and to examine the association of prescribing prevalence with obesity class. Methods: Study sample of adult patients (>18 years old) with depression was extracted from the national Canadian Primary Care Sentinel Surveillance Network (CPCSSN) Electronic Medical Records database for 2011-2016. Measures were prescribing of at least one AD (outcome) and body mass index (BMI) to categorize patients into weight categories (exposure). Data were analyzed cross-sectionally using descriptive statistics and mixed effects logistic regression model with clustering on CPCSSN networks and adjusting for age, sex, and the comorbidities. Results: Of 120,381 patients with depression, 63,830 patients had complete data on studied variables (complete cases analysis). Compared with normal weight patients, obese patients were more likely to receive an AD prescription (adjusted Odds Ratio [aOR] = 1.17; 95% Confidence Interval [CI]: 1.12-1.22). Patients with obesity classes II and III were 8% (95% CI: 1.00, 1.16) and 6% (95% CI: 0.98, 1.16) more likely, respectively, to receive AD. After imputing missing data using Multiple Imputations by Chained Equations, the results remained unchanged. The prevalence of prescribing >3 AD types was higher Puzhko et al. Antidepressants Prescribing in Patients With Obesity in obese category (7.27%, [95% CI: 6.84, 7.73]) than in normal weight category (5.6%; [95% CI: 5.24, 5.99]). Conclusion: The association between obesity and high prevalence of AD prescribing and prescribing high number of different AD to obese patients, consistent across geographical regions, raises a public health concern. Study results warrant qualitative studies to explore reasons behind the difference in prescribing, and quantitative longitudinal studies evaluating the association of AD prescribing patterns for obese patients with health outcomes.

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“…The data CPCSSN collects includes billing, patient demographic characteristics, problem list, and measurements such as weights and heights (3). Previous studies have examined CPCSSN data to estimate the prevalence of obesity in primary care but noted that WC was infrequently documented; but did not compare patient BMI category by WC category nor did they describe the demographic characteristics of patients who have WC documented (4). To the author's knowledge, there are no descriptions of BMI and WC measurements across multiple primary care EMR systems in the Canadian health system.…”

Section: Introductionmentioning

confidence: 99%

Body mass index and waist circumference documentation in Canadian primary care electronic medical records

Lindeman¹,

Jones²,

Cummings³

et al. 2020

Preprint

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Background: Electronic medical records (EMR) are commonly used in primary care to document patient measurements including height and weight that are then used to produce body mass index (BMI) scores. However, little is known about the proportion of waist circumference (WC) documentation compared to BMI and the characteristics of patients with these measures. This study used a pan-Canadian research database, sourced from primary care EMRs, to describe BMI and WC documentation in primary care. Methods: A retrospective cohort design of primary care providers participating in the Canadian Primary Care Sentinel Surveillance Network (CPCSSN), this study presented descriptive, observational findings of EMR inputs. Frequencies and percentages of median BMI and WC documentation in CPCSSN EMRs and patient demographic characteristics are compared. Results: Of 707,819 Canadian patients aged of 40 or older, at least one BMI input was recorded for 58.6% and 11.5% had WC notations. The majority of patients (98.1%) with at least one WC measurement also had a BMI measurement while conversely 19.2% of patients with at least one BMI measurement also had a WC measurement. The most common median BMI category was overweight (36.9%) and median WC was 95.0 centimetres (IQR = 21.5).Conclusions: This study reports the documentation of obesity and overweight in select Canadian primary care EMRs infrequently recorded WC when compared to BMI. Future studies should examine the frequency and categories of anthropometric measurements in people with commonly managed chronic conditions and whether BMI and WC inputs are missing at random. Trial registration: Not applicable for this study.

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Adult obesity prevalence in primary care users: An exploration using Canadian Primary Care Sentinel Surveillance Network (CPCSSN) data

Cited by 21 publications

References 14 publications

Prevalence of toddler, child and adolescent overweight and obesity derived from primary care electronic medical records: an observational study

Prevalence of toddler, child and adolescent overweight and obesity derived from primary care electronic medical records: an observational study

Evaluating Prevalence and Patterns of Prescribing Medications for Depression for Patients With Obesity Using Large Primary Care Data (Canadian Primary Care Sentinel Surveillance Network)

Body mass index and waist circumference documentation in Canadian primary care electronic medical records

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