The prevalence of obesity documentation in Primary Care Electronic Medical Records

Mattar, Ahmed; Carlston, David; Sariol, Glen; Yu, Tongle; Almustafa, Ahmad; Melton, Genevieve B.; Ahmed, Adil

doi:10.4338/aci-2016-07-ra-0115

Cited by 42 publications

(55 citation statements)

References 24 publications

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“…Furthermore, residual confounding due to stratification of obesity and non‐obesity may exist since dose‐response relationships between body mass index and outcomes of interest remain unknown due to the restrictions of the database. Obesity was underreported in the discharge records in the KID and other database, indicating that clinicians may not identified as an important problem in their care . The detailed clinical presentation and laboratory data were unavailable in the KID.…”

Section: Discussionmentioning

confidence: 99%

The impact of pediatric obesity on hospitalized children with lower respiratory tract infections in the United States

Okubo

Nochioka

Testa

2017

Clinical Respiratory J

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Section: Discussionmentioning

confidence: 99%

The impact of pediatric obesity on hospitalized children with lower respiratory tract infections in the United States

Okubo

Nochioka

Testa

2017

Clinical Respiratory J

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“…Although overweight and obesity (OW/OB) are highly prevalent in the USA [1][2][3] with rates of obesity of 26% in 2-5-year olds and 39.6% in adults [1,2], patients with OW/OB are often underdiagnosed by both resident physicians and attending physicians [4][5][6][7][8][9][10][11][12]. Accurately diagnosing OW/OB is becoming increasingly important as Medicare increasingly ties reimbursement to the complexity of patients and meaningful use criteria [10]. Further, incorporating OW/OB into the problem list can be an important first step to tracking OW/OB over time and addressing this issue with patients [4,7,8].…”

Section: Introductionmentioning

confidence: 99%

A resident-led project to improve documentation of overweight and obesity in a primary care clinic

Wang’ondu

Vitale

Rosenblum

et al. 2019

Journal of Community Hospital Internal Medicine Perspectives

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Background: Although the prevalence of overweight and obesity (OW/OB) has increased in the last three decades, studies show that these conditions are sub-optimally documented by physicians. Health information technology tools have varying effects on improving documentation of OW/OB but often have to be complemented with other interventions to be effective. Objective: Upon identifying low rates of documentation of diagnoses of overweight and obesity by resident and attending physicians, despite the use of an electronic health record (EHR) with automated BMI calculations, we performed a quality improvement (QI) project to improve documentation of these diagnoses for patients in our community hospital primary care clinic. Methods: The EHR was reviewed to determine documentation rates by resident and attending physicians between 1 March 2018 and 31 September 2018. We collected pre-intervention data, developed interventions, and implemented tests of change using Plan-Do-Study-Act (PDSA) cycles to improve documentation of OW/OB. Results: Documentation of overweight and obesity diagnoses increased from a baseline of 46% to 79% over a 20-week period after initiation of our project. Conclusion: We demonstrate the successful implementation of resident-led, multi-faceted interventions in a team-based QI project to optimize documentation of OW/OB in the EHR.

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“…The highest rate of physician obesity documentation occurred in patients with a BMI of 45 to 49.9 kg/m 2 with documentation occurring in the last 3 years. This illustrates that physicians more frequently acknowledge obesity as BMI increases and physicians find importance in documenting obesity as BMI increases . However, there was an unanticipated decline in patient perception and physician documentation of obesity for patients with a BMI ≥50 kg/m 2 .…”

Section: Discussionmentioning

confidence: 99%

“…This illustrates that physicians more frequently acknowledge obesity as BMI increases and physicians find importance in documenting obesity as BMI increases. 36 However, there was an unanticipated decline in patient perception and physician documentation of obesity for patients with a BMI ≥50 kg/m 2 . BMI ≥50 kg/m 2 may represent a threshold where patients have less insight into their obesity; patients and physicians are less comfortable discussing obese weight and weight management, and/or the majority visit time is spent managing comorbid illness than addressing the underlying obesity.…”

Section: Discussionmentioning

confidence: 99%

Patient perception of obesity versus physician documentation of obesity: A quality improvement study

et al. 2019

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As the prevalence of obesity increases, the prevalence of associated comorbid diseases, obesity‐related mortality rates and healthcare costs rise concordantly. Two main factors that hinder efforts to treat obesity include a lack of recognition by patients and documentation by physicians. This study evaluates the relationship between patient perception of obese weight and physician documentation of obesity. This quality improvement observational study surveyed patients of an academic internal medicine clinic on their perception of obesity. Responses were compared to longitudinal physician documentation of obesity and body mass index (BMI). A total of 59.9% of patients with obesity perceived their weight as obese. While 33.7% of patients with a BMI of 30 to 34.9 kg/m2 perceived themselves as having obesity, 71.4% of patients with a BMI of 45 to 49.9 kg/m2 perceived themselves as having obesity. A total of 42.4% of patients with obesity had physician documentation of obesity in the last year. While 25% of patients with a BMI of 30 to 34.9 kg/m2 had physician documentation of obesity, 85.7% of patients with a BMI of 45 to 49.9 kg/m2 had physician documentation of obesity. For patients with a BMI ≥50 kg/m2, 52.9% perceived their weight to be obese and 76.5% had physician documentation of obesity in the last year. Both patient perception and physician documentation of obesity were significantly less than the prevalence of obesity. Patient perception of obesity and provider documentation of obesity increased as BMI increased until a BMI ≥50 kg/m2. Both patients and providers must improve recognition of this disease.

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The prevalence of obesity documentation in Primary Care Electronic Medical Records

Cited by 42 publications

References 24 publications

The impact of pediatric obesity on hospitalized children with lower respiratory tract infections in the United States

The impact of pediatric obesity on hospitalized children with lower respiratory tract infections in the United States

A resident-led project to improve documentation of overweight and obesity in a primary care clinic

Patient perception of obesity versus physician documentation of obesity: A quality improvement study

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