Mismatch between the prevalence of overweight and obese children and adolescents and recording in electronic health records: a cross-sectional study

Abstract

Background The prevalence of obesity has increased dramatically in recent years. An electronic health record (EHR) can be used to identify and manage overweight and obesity by providing timely information. Objective To estimate the prevalence of overweight and obesity using anthropometric data from an EHR and to compare it with the frequency of diagnoses of 'overweight' and 'obesity' registered by pediatricians. Methods Cross-sectional, descriptive analytical study from a sample of records from children aged between 2 and 19 years who had at least one well-child visit registered in the EHR over the 24- month period between 2007 and 2008. The record of a diagnosis of overweight or obesity by physicians was comparedwith estimations based on body mass index (BMI; World Health Organization Growth Reference Data). Results Of 14 743 patients aged 2_19 years, 22.1% were overweight and 9.8% were obese. By contrast, a diagnosis of overweight was registered in the EHR for 3.3% of patients, with a figure of 1.1% for obesity. The prevalence of overweight/obesity was lower in adolescents than in children and preschoolers. Based on BMI cut-off points, we found that only 11.5% of the overweight or obese patients had these diagnoses registered in the EHR. Referral to a nutritionist or endocrinolist, and the frequency of selected laboratory tests based on BMI categories vary between 11.8 and 52.5%. Conclusion An EHR can contribute to the identification of a population at risk when there is a subregistry of these diagnoses by primary care physicians.

Keywords

• adolescent
• attitude of health personnel
• body mass index
• child
• computerised medical record system
• obesity
• overweight
• prevalence