scholarly journals Health professionals’ adherence to evidence-based obesity guidelines: a cohort study.

2019 ◽  
Author(s):  
Nuria Trujillo Garrido ◽  
Mariangeles Bernal ◽  
Maria José Santi Cano
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Health Professionals ◽  
Medical Records ◽  
Scientific Evidence ◽  
Behavioural Change ◽  
Overweight And Obesity ◽  
Evidence Based ◽  
Practice Methods ◽  
Evidence Based Guidelines

Abstract BACKGROUND The prevalence of obesity is on the increase worldwide and yet scientific evidence shows that primary care professionals are not adequately addressing overweight and obesity. In this study, we evaluate how obesity guidelines are being implemented in routine clinical practice. METHODS The study obtained the following data on a cohort of 209 obese patients attending primary care consultations: electronic medical records, body mass index (BMI), waist circumference (WC), cardiovascular risk factors, comorbidities and whether or not their health professional adhered to obesity evidence-based guidelines. RESULTS 57.9% of the participants were women and their average age was 65.8 ± 12.7 years. Only 25.4% of the medical records met all the criteria established in the therapeutic guidelines regarding diet prescription. This percentage was significantly higher in males than females (36.4% vs 17.4, p = 0.002). 1.4% met the criteria for physical activity and 1.5% for behavioural change activities. In the multivariate analysis, the variable associated with the most favourable BMI and WC figures, after adjusting for age, was a follow up by health professionals on physical activity (β=0.347, p=0.027, CI=0.429-6.868; β=0.367, p=0.024, CI=1.256-17.556) during routine check-ups with women. CONCLUSIONS We detected low adherence to the evidence-based guidelines among professionals. Recording dietetic prescription and physical exercise in the patient's medical record is associated with a better control of obesity. This data suggest that primary health care should be improved for obese patient.

scholarly journals Evaluation of Obesity Management Recorded in Electronic Clinical History: A Cohort Study

2020 ◽  
Vol 9 (8) ◽  
pp. 2345
Author(s):  
Nuria Trujillo-Garrido ◽  
María Ángeles Bernal-Jiménez ◽  
María J. Santi-Cano
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Primary Care Physicians ◽  
Clinical History ◽  
Evidence Based ◽  
Therapeutic Guidelines ◽  
Close Proximity ◽  
Prevalence Of Obesity ◽  
Clinical Records ◽  
Practice Methods

Background: The prevalence of obesity is increasing worldwide. Because of their close proximity to the population, primary care physicians and nurses are in a unique position to motivate and advise patients with obesity on a healthy diet and increased physical activity. Drawing from information recorded in electronic clinical records, we evaluated how the general recommendations included in obesity guidelines are being implemented in routine clinical practice. Methods: This study drew from the following data from a cohort of 209 patients with obesity that attended primary care consultations: electronic clinical records, body mass index (BMI), waist circumference (WC), cardiovascular risk factors, comorbidities and whether their health professional documented compliance with the recommendations of the evidence-based obesity guidelines in their electronic history. Results: Only 25.4% of the clinical records met all the criteria established in the therapeutic guidelines regarding diet prescription, 1.4% for physical activity and 1.5% for behavioral change activities. The patients whose records mentioned diet prescription and physical activity and who received follow-up consultations for both factors had lower average BMI and WC, although this relationship was not significant after adjusting for baseline. Conclusions: We found that only a small number of records in the electronic clinical histories followed the evidence-based obesity guidelines. Recording dietetic prescription and physical exercise in the patient’s clinical record is associated with better control of obesity.

scholarly journals Management of overweight and obesity in primary care—A systematic overview of international evidence‐based guidelines

2019 ◽  
Vol 20 (9) ◽  
pp. 1218-1230 ◽  
Author(s):  
Thomas Semlitsch ◽  
Florian L. Stigler ◽  
Klaus Jeitler ◽  
Karl Horvath ◽  
Andrea Siebenhofer
Keyword(s):  
Primary Care ◽  
Overweight And Obesity ◽  
Evidence Based ◽  
International Evidence ◽  
Systematic Overview ◽  
Evidence Based Guidelines

Experiences in physical activity promotion in health care settings for primary prevention in the UK

2014 ◽  
Vol 62 (2) ◽  
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Health Professionals ◽  
Controlled Trial ◽  
Full Range ◽  
Tertiary Care ◽  
Physical Activity Promotion ◽  
Community Based ◽  
Activity Promotion ◽  
Randomised Controlled

In addition to the delivery of primary care services, recent changes to the NHS in the United Kingdom have placed increasing responsibility on GPs for the commissioning of the full range of health services from prevention through to clinical interventions and rehabilitation. Whilst historically there has always been an expectation that primary care professionals were ideally placed to provide support for prevention as well as treatment, their active engagement in the promotion of physical activity has remained largely superficial. With notable exceptions where individuals have a personal interest or commitment, the majority of health professionals tend to limit themselves to peremptory non-specific advice at best, or frequently don’t broach the subject at all. There are a number of reasons for this including increasing time pressures, a general lack of knowledge, limited evidence and concerns about litigation in the event of an adverse exercise induced event. However in the 1990s there was a surge of interest in the emerging “Exercise on Prescription” model where patients could be referred to community based exercise instructors for a structured “prescription” of exercise in community leisure centres. Despite the continuing popularity of the model there remain problems particularly in getting the active support of health professionals who generally cite the same barriers as previously identified. In an attempt to overcome some of these problems Wales established a national exercise referral scheme with an associated randomised controlled trial. The scheme evaluated well and had subsequently evolved with new developments including integration with secondary and tertiary care pathways, accredited training for exercise instructors and exit routes into alternative community based exercise opportunities.

scholarly journals Safe and effective praxis without scientific evidence: is it possible?

2020 ◽  
Vol 19 (3) ◽  
pp. 178
Author(s):  
Jefferson Petto ◽  
Igor Macedo De Oliveira ◽  
Alice Miranda De Oliveira ◽  
Marvyn De Santana Do Sacramento
Keyword(s):  
Decision Making ◽  
Health Professionals ◽  
Scientific Literature ◽  
Evidence Based Practice ◽  
Scientific Evidence ◽  
Science And Technology ◽  
Evidence Based ◽  
Scientific Thought ◽  
Daily Lives

The earliest accounts of scientific thought date back to thousands of years BC, where problems in the daily lives of our predecessors led to the search for effective and replicable forms of resolution. Nowadays, in the advent of science and technology, health professionals' decision making has been organized based on the analysis of the diverse evidence available in the scientific literature. This process has been identified Evidence Based Practice (EBP)...

scholarly journals 58 Overweight and obesity in children with autism spectrum disorder: Findings from primary care electronic medical records

2020 ◽  
Vol 25 (Supplement_2) ◽  
pp. e24-e24
Author(s):  
Laura M Kinlin ◽  
Sarah Carsley ◽  
Charles Keown-Stoneman ◽  
Natasha Saunders ◽  
Karen Tu ◽  
...  
Keyword(s):  
Primary Care ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Weight Status ◽  
Severe Obesity ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Overweight And Obesity ◽  
Typically Developing ◽  
Increased Risk

Abstract Introduction/Background Paediatric overweight and obesity are important public health problems worldwide. Children with autism spectrum disorder (ASD) may be at increased risk compared to their typically-developing peers; however, prevalence estimates in ASD have varied widely and existing studies have largely been limited by use of an external comparison group. Objectives To compare prevalence of overweight and obesity in children and youth (<19 years of age) with and without ASD, using electronic medical record data from paediatric primary care visits. Design/Methods This was a cross-sectional analysis of EMRPC (Electronic Medical Records Primary Care) data, representing 385 family physicians in 43 clinics in Ontario, Canada. Age- and sex-standardized body mass index (BMI) z-scores were calculated using abstracted heights and weights from the most recent visit between January 2011 and December 2015. Weight status was determined using World Health Organization growth reference standards. ASD was defined using a previously-validated algorithm in EMRPC, based on an ASD-related term in the ‘Cumulative Patient Profile.’ Chi-square test statistics and multinomial logistic regression were used to compare weight status of those with and without ASD. Results In total, 44,625 children and youth were included, 632 [1.42%] with ASD. Distribution of weight status was significantly different between those with and without ASD (p<0.001) [Table 1]. Compared to their typically-developing peers, children with ASD had significantly higher odds of overweight (unadjusted odds ratio [OR] 1.52; 95% confidence interval [CI] 1.24-1.87), obesity (unadjusted OR 2.55 (2.00-3.26) and severe obesity (unadjusted OR 3.09; 95% CI 2.08-4.60); these associations persisted after adjusting for sex, age, neighborhood income quintile and rural residence (Table 2). Conclusion Data from a large primary care database suggest that children with ASD are at substantially increased risk of overweight, obesity and severe obesity. Findings support the need for anticipatory guidance, prevention and management strategies specific to this clinical population. Future work will aim to better understand at what age differences in weight status emerge, and what nutritional, behavioural, or medical factors differentially affect weight status in the ASD population.

scholarly journals The extent to which family physicians record their patients’ exercise in medical records: a scoping review

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e034542 ◽  
Author(s):  
Cliff Lindeman ◽  
Ashley McCurdy ◽  
Carminda G Lamboglia ◽  
Brendan Wohlers ◽  
Anh N Q Pham ◽  
...  
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Health Promotion ◽  
Electronic Medical Records ◽  
Family Physician ◽  
Scoping Review ◽  
Medical Records ◽  
Chronic Conditions ◽  
Geographic Origin ◽  
Family Physicians

ObjectiveExercise is an effective modality for the prevention and treatment of chronic conditions and family physicians are the healthcare providers tasked to manage patients’ chronic disease status. However, little is known about the exercise documentation in family-physician records. Therefore, a scoping review was conducted to describe family-physician-recorded exercise-related advice to patients in electronic medical records.DesignScoping review.SettingPrimary care clinics.Search strategyPubMed, Medline, SPORTDiscus, Google, Dissertations & Theses Global, OCLC PapersFirst (via First Search) and included references were searched between 1 January 1990 and 10 June 2018. Extracted information included year, geographic origin, data input structure, input frequency and content of exercise inputs in family physicians’ electronic medical records. The primary outcomes are the structure, purpose and frequency of inputs.ResultsOf a possible 1758 documents, 83 remained after a title and abstract scan and 22 after a full-text review. These documents included 32 findings of physical activity/exercise medical record documentation: counselling/advising patients (50.0%), status (12.5%), embedded questionnaires (12.5%), status as a risk factor (12.5%), health promotion documentation (6.3%), inactivity status (3.1%) and grading (3.1%). The frequency of exercise inputs in primary care records vary from as low as 0.4% of patients with documentation of physical activity health promotion inputs to as high as 87.8% of patients with exercise or physical activity status recorded. The majority of included documents (63.6%) were focused on patients with identified chronic conditions.ConclusionThe findings suggest that the structure and purpose of exercise documentation is often unclear or unspecified. Studies that present exercise information from family-physician medical records tend to focus on patients with specific chronic conditions and present little detail about the field from which information was extracted. The review found that the proportion of patients with physical activity or exercise information is often less than half.

scholarly journals Diet and physical activity as determinants of weight gain, overweight and obesity: The WCRF/AICR evidence and policy implications

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Isobel Bandurek ◽  
Emily Almond ◽  
Susannah Brown ◽  
Giota Mitrou ◽  
Ifigeneia Bourgiezi ◽  
...  
Keyword(s):  
Public Health ◽  
Physical Activity ◽  
Health Policy ◽  
Weight Gain ◽  
Public Health Policy ◽  
Screen Time ◽  
Overweight And Obesity ◽  
Evidence Based ◽  
Diet And Physical Activity ◽  
Adults And Children

AbstractIntroductionGlobally, over 1.97 billion adults and 338 million children and adolescents are living with overweight and obesity, increasing the risk of numerous co-morbidities, including at least 12 cancers(1). WCRF/AICR conducted a literature review of diet and physical activity as determinants of weight gain, overweight and obesity in adults and children. We also introduce a novel evidence-based policy framework for promoting physical activity, and linked database, currently in development as part of the EU-funded CO-CREATE project on child and adolescent obesity prevention.Materials and MethodsEvidence on diet and physical activity as determinants and risk of weight gain, overweight and obesity was systematically extracted from existing reviews and a systematic search for recent meta-analyses, then collated and analysed. The WCRF Continuous Update Project Expert Panel drew conclusions about which exposures influence risk of weight gain, overweight and obesity, using pre-defined criteria that included evidence of biological plausibility.ResultsThe Panel identified strong evidence that several diet and physical activity related exposures influence the risk of weight gain, overweight and obesity in adults and children (see table 1). Separate conclusions were drawn for adults and children in relation to screen time, considered a marker of sedentary time.However, the Panel noted that as exposures tend to cluster, physiologically interact and share common biological mechanisms, they should not be regarded as absolutely ‘singular'but an integrated concept of interrelated exposures within a pattern of lifestyle. Table 1.Risk of weight gain, overweight and obesitySTRONG EVIDENCEDECREASES RISKINCREASES RISKCONVINCINGWalkingScreen time (children)Sugar sweetened drinksPROBABLEAerobic physical activityFoods containing dietary fibre‘Mediterranean type’ dietary patternHaving been breastfedScreen time (adults)‘Fast foods’‘Western type’ dietFor full list of footnotes, see Energy Balance and Body Fatness report(1).DiscussionHealthy dietary patterns help prevent excess weight gain. Achieving such patterns requires attention to the broader economic, environmental and social factors that influence and constrain people's behaviour. The findings of this report support the need for evidence-based public health policy to help create health-enabling environments, particularly for children and adolescents. The WCRF International MOVING framework(2) presents a package of policies to promote physical activity, which alongside wider public health policy can help address the multiple drivers of overweight and obesity.

Safety, Efficacy, and Cost Effectiveness of Evidence-Based Guidelines for the Management of Acute Low Back Pain in Primary Care

Spine ◽  
2001 ◽  
Vol 26 (23) ◽  
pp. 2615-2622 ◽  
Author(s):  
Brian McGuirk ◽  
Wade King ◽  
Jayantilal Govind ◽  
John Lowry ◽  
Nikolai Bogduk
Keyword(s):  
Primary Care ◽  
Low Back Pain ◽  
Back Pain ◽  
Cost Effectiveness ◽  
Evidence Based ◽  
Low Back ◽  
Acute Low Back Pain ◽  
Evidence Based Guidelines
Sign in / Sign up

Export Citation Format

Share Document