South West Public Health Training Programme.
School of Social and Community Medicine, University of Bristol, Bristol.
Br J Gen Pract. 2017 Oct;67(663):e676-e683. doi: 10.3399/bjgp17X692309. Epub 2017 Aug 28.
Primary care guidelines for managing adult overweight/obesity recommend routine measurement of body mass index (BMI) and the offer of weight management interventions. Many studies state that this is rarely done, but the extent to which overweight/obesity is recognised, considered, and documented in routine care has not been determined.
To identify the epidemiology of adult overweight documentation and management by UK GPs.
A systematic review of studies since 2006 from eight electronic databases and grey literature.
Included studies measured the proportion of adult patients with documented BMI or weight loss intervention offers in routine primary care in the UK. A narrative synthesis reports the prevalence and pattern of the outcomes.
In total, 2845 articles were identified, and seven were included; four with UK-wide data and three with regional-level data. The proportion of patients with a documented BMI was 58-79% (28-37% within a year). For overweight/obese patients alone, 43-52% had a recent BMI record, and 15-42% had a documented intervention offer. BMI documentation was positively associated with older age, female sex, higher BMI, coexistent chronic disease, and higher deprivation.
BMI is under-recorded and weight loss interventions are under-referred for primary care adult patients in the UK despite the obesity register in the Quality and Outcomes Framework (QOF). The review identified likely underserved groups such as younger males and otherwise healthy overweight/obese individuals to whom attention should now be directed. The proposed amendment to the obesity register QOF could prompt improvements but has not been adopted for 2017.
管理成年超重/肥胖的初级保健指南建议常规测量体重指数（BMI）并提供体重管理干预措施。许多研究表明，这很少被执行，但超重/肥胖在常规护理中被识别、考虑和记录的程度尚未确定。
确定英国全科医生管理成年超重的流行病学情况。
对 2006 年以来八个电子数据库和灰色文献中的研究进行系统回顾。
纳入的研究测量了英国常规初级保健中记录有 BMI 或体重减轻干预措施的成年患者的比例。叙述性综合报告了结果的流行率和模式。
共确定了 2845 篇文章，其中 7 篇被纳入；其中 4 项为全英范围的数据，3 项为区域水平的数据。有记录 BMI 的患者比例为 58-79%（一年内为 28-37%）。仅针对超重/肥胖患者，最近有 BMI 记录的患者比例为 43-52%，有记录的干预措施的患者比例为 15-42%。BMI 记录与年龄较大、女性、较高 BMI、并存的慢性疾病和较高的贫困程度呈正相关。
尽管质量和结果框架（QOF）中有肥胖登记，但英国的初级保健成年患者 BMI 记录不足，体重减轻干预措施的推荐不足。该审查确定了一些可能服务不足的群体，如年轻男性和其他健康的超重/肥胖个体，现在应该关注这些群体。QOF 肥胖登记的拟议修正案可能会促使情况得到改善，但尚未在 2017 年采用。
