Cuccu Zara, Abi-Aad Gerrard, Duggal Allison
Department of Public Health, Kent County Council, Maidstone, UK
Department of Public Health, Kent County Council, Maidstone, UK.
BMJ Health Care Inform. 2019 Jun;26(1). doi: 10.1136/bmjhci-2019-000026.
Obesity is a significant health issue and key public health priority. This study explored body mass index (BMI) recording in general practice within the Kent Integrated Dataset.
Using a sample aged 18-100 years, resident within Kent, who were alive and currently registered to a Kent general practice as of 6 August 2018 within the Kent Integrated Dataset. We identified the latest BMI from event records between 2015/2016 and 2017/2018. Recording was evaluated by sex, age, deprivation, hypertension, serious mental illness and multimorbidity.
Between 2015/2016 and 2017/2018 using the sample of 1 154 652 persons, BMI was recorded for 43.7% of the sample. Multiple logistic regression showed that BMI recording was higher in females, the middle age bands, persons living in the most deprived areas and within persons who were hypertensive, had serious mental illness or were multimorbid.
Findings were aligned to previous research using nationally representative samples. Completeness of recording varied by age, sex, deprivation and comorbidity. Recording within general practice was aligned to chronic disease management. From a prevention perspective, earlier assessment and intervention for the management of excess weight within primary care may be an opportunity for avoiding increases in BMI trajectory. There may also be merit in recognising that the external disease agents that influence obesity can be controlled or reduced (obesogenic environment) from a national policy perspective. Such a perspective may also help reduce stigmatisation and the pressure around arguments that centre on personal responsibility for obesity.
肥胖是一个重大的健康问题，也是关键的公共卫生重点。本研究在肯特综合数据集中探索了全科医疗中体重指数（BMI）的记录情况。
使用肯特郡18至100岁的居民样本，这些居民截至2018年8月6日在世且目前在肯特综合数据集中注册于肯特郡的全科医疗。我们从2015/2016年至2017/2018年的事件记录中确定了最新的BMI。记录情况按性别、年龄、贫困程度、高血压、严重精神疾病和多种疾病并存情况进行评估。
在2015/2016年至2017/2018年期间，以1154652人的样本为例，43.7%的样本记录了BMI。多元逻辑回归显示，女性、中年人群、生活在最贫困地区的人群以及患有高血压、严重精神疾病或多种疾病并存的人群中，BMI记录率更高。
研究结果与之前使用全国代表性样本的研究一致。记录的完整性因年龄、性别、贫困程度和合并症而异。全科医疗中的记录与慢性病管理一致。从预防角度来看，在初级保健中对超重管理进行更早的评估和干预可能是避免BMI轨迹上升的一个机会。从国家政策角度认识到影响肥胖的外部致病因素可以得到控制或减少（致胖环境）也可能有好处。这样的观点也可能有助于减少污名化以及围绕肥胖个人责任的争论压力。
