When is family history obtained? - Lack of timely documentation of family history among overweight and hypertensive paediatric patients.

AIM

Taking a detailed family history is an inexpensive way for healthcare providers to screen patients for increased risk of various chronic conditions. Documentation of family history, however, has been shown to be incomplete in the majority of patient charts. The current study examines when family history is collected within the context of the development and diagnosis of chronic conditions in paediatrics, using hypertension and overweight/obesity as examples.

METHODS

We analysed family history data from the electronic medical records of 5485 overweight/obese and 774 hypertensive children and adolescents in a large, urban medical system in northeast Ohio. Manual review of 200 charts was also performed.

RESULTS

Family history information was entered prior to the development of hypertension in 13.5% of hypertensive patients with a family history of hypertension, and it was entered prior to the development of abnormal weight in 35.5% of overweight/obese patients with a family history of obesity or a related condition. Of patients with a relevant family history who received an actual diagnosis for either of these conditions, only 16.7% of hypertensive and 33.3% of overweight/obese patients had this family history documented prior to diagnosis.

CONCLUSIONS

These results imply that paediatric providers may not use family history as a screening tool for assessing future risk of obesity and hypertension, but instead gather this information after these chronic conditions have developed, making it difficult to implement preventative or screening strategies based on familial risk.