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Chronic disease management principles aid in treating pediatric obesity

WASHINGTON — According to a two-part study presented at the 2015 AAP National Conference and Exhibition, applying comprehensive chronic disease management principles to treating pediatric obesity was effective in a primary care setting.

“Our project had two different parts. The first portion focused on education and improvement of quality measures within our clinics, so that we could work harder at addressing obesity effectively in the short amount of time that is allotted in office visits,” study researcher Cicely White, MD, of Group Health Permanente, Spokane, Washington, told Infectious Diseases in Children. “The second component of our project involved a multidisciplinary program to target families and children for treatment of obesity, which showed significant success in decreasing the BMIs of those children involved in the group.”

The researchers employed Countdown to Healthy Living, a comprehensive diet management program that teaches families to focus on diet management skills. A cohort of 49 children aged 6 to 11 years with BMI above the 85th percentile were enrolled in 12 weekly family sessions. Sessions included education on behavior-based lifestyle changes designed to reduce or manage weight, goal setting, nutrition and physical activity. The program also educated families on a focused daily diet, including five servings of fruits and vegetables, at least four glasses of water, three cups of low fat milk, and no sugar-sweetened beverages.

Electronic medical record tools were used to standardize the process of obesity diagnosis and treatment. Survey questionnaires were used to gather data from physicians and families before and after the program.

Data showed that 40% of children experienced some reduction in BMI after 2 years, although only 35% of enrolled families continued with the program for longer than 6 weeks. The researchers said that parents and children reported an improved quality of care experience from their pediatrician after the program.

The researchers also noted that 80% of physicians in the study reported unfamiliarity with the practice guidelines for pediatric obesity before the study; however, they reported improved compliance with clinical practice guidelines after program participation.

“You can address these issues in a routine well visit,” Nalini Gupta, MBBS, MD, FAAP, also of Group Health Permanente, told Infectious Diseases in Children. “You can bring up the obesity conversation. It does not need to be done all in one visit, but families are more than willing to come back and talk about it.” – by David Costill

Reference:
Gupta N, et al. Abstract 29714. Presented at: AAP National Conference and Exhibition; Oct. 24-27, 2015; Washington, D.C.

Disclosure: The researchers report no relevant financial disclosures.