Obesity management in general practice: does current practice match guideline recommendations?

Abstract

Objective: To assess the documentation of measures recommended in the National Health and Medical Research Council clinical practice guidelines for managing overweight and obesity in adults, adolescents and children in Australia.

Design, setting and participants: Retrospective analysis of routine general practice data from 270,426 adult patients. Data were extracted from the Melbourne East Monash General Practice Database, collected from general practice clinics located in the inner-eastern Melbourne region between 1 July 2011 and 31 December 2013.

Main outcome measures: Documentation of quantitative measures of obesity identified in the national guidelines - specifically, body mass index (BMI) and waist circumference.

Results: 22.2% and 4.3% of patients had a BMI and waist circumference, respectively, recorded in their computerised medical records. There were variations in BMI documentation across age and sex, with those aged over 75 years (odds ratio [OR], 1.60; 95% CI, 1.48-1.72) more likely, and women (OR, 0.86; 95% CI, 0.78-0.94) less likely to have a documented BMI. Patients with diabetes (OR, 1.85; 95% CI, 1.70-1.99) or who were prescribed diabetes-related medication (OR, 1.24; 95% CI, 1.12-1.35), those with hypertension (OR, 1.18; 95% CI, 1.11-1.24) or hyperlipidaemia (OR, 1.26; 95% CI, 1.20-1.33) were more likely to have a documented BMI.

Conclusions: Recording of measures of obesity in general practice is currently not consistent with guideline recommendations. Strategies to support general practitioners may improve their documentation of measures of obesity.