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抑郁、焦虑与呼吸急促被遗漏:新南威尔士州某区域基层医疗中的体重筛查

Depressed, anxious and breathless missing out: Weight screening in general practice in a regional catchment of New South Wales.

作者信息

Ghosh Abhijeet

机构信息

COORDINARE - South Eastern NSW PHN, Wollongong, New South Wales, Australia.

出版信息

Aust J Rural Health. 2016 Aug;24(4):246-52. doi: 10.1111/ajr.12264. Epub 2015 Dec 23.

Abstract

OBJECTIVE

To assess the recording status of weight management measures among adults presenting to general practices within regional catchments.

DESIGN

Cross-sectional; secondary data analysis.

SETTING

Primary health care - 17 general practices located in the Illawarra Shoalhaven region of regional New South Wales.

PARTICIPANTS

A subset of the Sentinel Practices Data Sourcing project database (n = 118 709 adults) that included information on demographic indicators, chronic disease status, and obesity and overweight-specific measurement indicators recorded from September 2011 to September 2013.

MAIN OUTCOME MEASURES

Proportions of coded recording of quantitative measures of overweight and obesity - body mass index (BMI) and waist circumference, and likelihood of BMI recording (odds ratios (ORs)) by various clinical diagnosis and counts of recorded conditions.

RESULTS

Of the patients, 30.9% had a BMI recorded and only 8.0% had a waist circumference recorded in their electronic medical records. There were variations in BMI recording across age with those aged 45-64 years more likely (aOR = 1.25; 95% confidence interval (CI), 1.21-1.29; P-value < 0.001) to have a recorded BMI. Patients with mental health conditions (a OR = 0.80; 95% CI, 0.76-0.84; P-value < 0.001) and patients with respiratory conditions (aOR = 0.91; 95% CI, 0.86-0.96; P-value = 0.001) were significantly less likely to have a BMI recorded.

CONCLUSIONS

Recording of measures of obesity and overweight in general practices within regional settings is much lower than optimal. More support and advocacy around weighing patients at all interactions is required for regional general practitioners to increase the weight screening in primary care. These findings have policy-relevant implications for weight management in regional Australia.

摘要

目的

评估在区域集水区内就诊于普通诊所的成年人中体重管理措施的记录情况。

设计

横断面研究;二次数据分析。

地点

初级卫生保健机构——位于新南威尔士州地区伊拉瓦拉肖尔黑文地区的17家普通诊所。

参与者

哨兵实践数据溯源项目数据库的一个子集(n = 118709名成年人),其中包括2011年9月至2013年9月记录的人口统计学指标、慢性病状况以及肥胖和超重特定测量指标的信息。

主要观察指标

超重和肥胖定量测量指标——体重指数(BMI)和腰围的编码记录比例,以及根据各种临床诊断和记录疾病计数得出的BMI记录可能性(比值比(OR))。

结果

在患者中,30.9%的人在电子病历中有BMI记录,只有8.0%的人有腰围记录。BMI记录在不同年龄组存在差异,45 - 64岁的人更有可能(校正后OR = 1.25;95%置信区间(CI),1.21 - 1.29;P值<0.001)有记录的BMI。患有精神疾病的患者(校正后OR = 0.80;95% CI,0.76 - 0.84;P值<0.001)和患有呼吸系统疾病的患者(校正后OR = 0.91;95% CI,0.86 - 0.96;P值 = 0.001)记录BMI的可能性显著降低。

结论

区域环境下普通诊所中肥胖和超重测量指标的记录远低于最佳水平。区域全科医生需要在所有诊疗过程中获得更多关于为患者称重的支持和倡导,以增加初级保健中的体重筛查。这些发现对澳大利亚区域的体重管理具有政策相关意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f39/5064649/1ff390a98b3e/AJR-24-246-g001.jpg

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