School of Social and Community Medicine, University of Bristol, Bristol, UK.
Br J Gen Pract. 2011 Aug;61(589):e492-7. doi: 10.3399/bjgp11X588466.
The rapid increase in the prevalence of childhood obesity in recent years has led to inconclusive debate about the most effective way to manage the condition and the most appropriate care setting. Primary care has been suggested as a key site to identify and treat obesity in children.
To identify children from general practice databases with a body mass index (BMI) categorised as 'obese', and invite them for a primary care consultation and possible referral to a specialist secondary care clinic.
Targeted screening of GP practice databases for obese children in 12 general practices in Bristol, UK.
Participating GP practices searched databases for children's BMIs which were then screened by the study team to identify obese children (≥98th centile). Practices invited families of obese children to consult their GP with the potential for referral to a specialist clinic. Follow-up data was recorded with respect to: consultations; consultations about child's weight; and referrals to specialist clinic; and other referrals.
A total of 285 letters inviting families to consult their GP were sent; 134 patients consulted their GP in the follow-up period (minimum 3 months), and 42 of these consultations discussed the child's weight. Nineteen patients received a secondary care referral and six received an alternative weight-management referral.
The low take-up following the mail-out of an invitation to consult highlights the inherent difficulties of engaging families and their obese children in care pathways that facilitate long-term weight management.
近年来，儿童肥胖症的患病率迅速上升，导致人们对于管理该病症的最有效方法和最合适的护理场所存在争议。初级保健被认为是识别和治疗儿童肥胖症的关键场所。
从普通科医生数据库中确定身体质量指数（BMI）被归类为“肥胖”的儿童，并邀请他们进行初级保健咨询，并可能转介到专门的二级保健诊所。
在英国布里斯托尔的 12 家普通科医生实践中，针对肥胖儿童进行有针对性的普通科医生实践数据库筛查。
参与的普通科医生实践在数据库中搜索儿童的 BMI，然后由研究小组对其进行筛查，以确定肥胖儿童（≥第 98 百分位数）。实践邀请肥胖儿童的家庭咨询他们的全科医生，并有可能转介到专门的诊所。记录了与以下方面相关的随访数据：咨询；关于儿童体重的咨询；以及向专科诊所的转介；和其他转介。
共发出了 285 封邀请家庭咨询全科医生的信件；在随访期间（至少 3 个月），有 134 名患者咨询了他们的全科医生，其中 42 次咨询讨论了儿童的体重。19 名患者接受了二级保健转介，6 名患者接受了替代体重管理转介。
发出咨询邀请后的参与率较低，这突出了使家庭及其肥胖儿童参与促进长期体重管理的护理途径所固有的困难。
