General practitioners are not routinely documenting obesity indicators such as Body Mass Index and Waist Circumference, lessening the potential positive effect they could have on healthy weight outcomes, according to research published online by the Medical Journal of Australia.
Clinical practice guidelines for managing overweight and obesity in adults, adolescents and children in Australia have been developed by the National Health and Medical Research Council (NHMRC).
However, researchers led by Dr Lyle Turner, Biostatistician from the Department of General Practice at Monash University in Melbourne, used data from the Melbourne East Monash General Practice Database to show that GPs are not recording measures of obesity as recommended by those guidelines.
Of 270 426 adult patients seen at clinics in inner east Melbourne between July 2011 and December 2012, only 22.2% (59 987) had their body mass index (BMI) recorded, and just 4.3% (11 684) of patients had their waist circumference recorded.
Patients aged over 75 years were more likely to have a BMI recorded, but women overall were less likely to have measures of obesity documented. Patients with diabetes, hypertension or hyperlipidaemia and those who were prescribed diabetes-related medications were more likely to have a documented BMI.
"Primary health care, generally the first point of contact for people seeking health services, has been identified as a good environment for implementing strategies for preventing and managing obesity", the researchers wrote.
"The [NHMRC] guidelines emphasise patient engagement in decision making, tailored recommendations, comanagement and/or referral, and long-term follow-up with regular monitoring by a general practitioner."
Hurdles to increasing screening for obesity in general practice include "problems in identifying obesity in the patient, difficulty in approaching the discussion of obesity, a perceived lack of appropriate training, and clinical software restrictions", the authors wrote.
The low rates of documentation of obesity measures "imply a continued need for programs of support to increase obesity screening and documentation of related clinical information". They suggested strategies such as primary care organisations assigning practice liaison officers to generate regular feedback on data quality and population-level health indicators, but emphasised that more research was needed.
"Continued research is required to assess how documentation of obesity-related clinical information changes over time as the NHMRC guidelines on managing overweight and obesity become embedded in clinical practice, and to examine barriers and enablers to increased obesity screening", the researchers concluded.
"To improve the quality of patient care, GPs should be supported to increase levels of obesity screening in accordance with the NHMRC guidelines."