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PCPs inconsistent in meeting benchmarks with Latino children who are overweight, obese

Communication of weight-related information is often not conducted during primary care visits with Latino children who are overweight or obese, according to research recently published in Global Pediatric Health.

“This is the first study, to our knowledge, to examine the relationship between directly observed provider-patient communication regarding weight-management benchmarks and associated [electronic medical record] documentation,” Christy Turer, MD, MHS, University of Texas Southwestern, Dallas, and colleagues wrote. “A novel study finding is that many benchmarks of quality weight-management care are not met during primary care visits with overweight Latino children.”

Christy Turer

Turer and colleagues recruited participants from several clinics, then recorded communications during primary care visits with Latino children aged 6 to 12 years old and considered overweight or obese to check for five benchmarks:

• keeping up long-term treatment;
• designating treatment goals;
• conducting thorough physical examinations;
• determining any weight-related disorders; and
• interpreting/determining BMI for age.

They found that benchmarks were neither communicated nor documented in up to 42% of visits, and communicated but not documented, or vice versa, in up to 20% of visits. In addition, a multivariable analysis showed that overweight (vs. obesity) was linked with 1.6 times more discrepancies in communication vs. documentation (P = .03).

“Importantly, study data suggest that many benchmarks are documented without being communicated — notably, weight-related physical examination findings, family history, and goals for weight maintenance or loss,” the researchers wrote. “For clinicians, these findings are important because improved communication with patients and families about these benchmarks might affect their motivation to make healthy lifestyle changes.”

Turer offered ways that clinicians can help discuss their concerns about a patient’s weight with that patient’s parents.

“[Clinicians should] tell families that the child is overweight using family-preferred terms such high weight or unhealthy weight. They should point out risk or presence of weight-related conditions, including asking about family history of diabetes, high BP or cholesterol, or heart disease, communicating when the child has an elevated BP or other markers of health problems, like skin darkening associated with diabetes risk and screening for diabetes, fatty liver disease, and high cholesterol when indicated, communicate the results, and perform the follow up needed for identified conditions,” she told Healio Family Medicine. “Agree on treatment goals, including time spent using TVs, video games, computers, tablets, and cell phones [and performing] physical activity and [suggesting] dietary changes.” – by Janel Miller

Disclosure: The researchers report no relevant financial disclosures.