Abstract
Background:
Standardized workflows supporting primary care provider (PCP) detection and management of obesity and its comorbidities are lacking in resource-poor settings. We evaluated the use of technological and visual aids to support PCP documentation, assessment, and management of comorbidities in youth with overweight and obesity.
Methods:
A prospective electronic medical record (EMR) chart review evaluated the impact of technological (EMR SmartPhrases) and visual (graphic and written reminders) aids, as well as provider training, on standardizing provider documentation and management of overweight- and obesity-related comorbidities during health care maintenance visits. Baseline intervention (T0) and postintervention (T1, T2, and T3) assessments were conducted from March 2022 to June 2023. Patient charts of children aged 5–12 years with overweight and obesity were reviewed for PCP identification of comorbidities, relevant laboratory orders, plans, and 3-month follow-up. T1, T2, and T3 measures were compared with T0 measures using Fisher’s exact test and t-test for categorical and continuous variables, respectively.
Results:
Of 100 baseline and 300 postintervention charts reviewed, 3-month follow-up visits increased significantly in patients with overweight and class 1 obesity (3%–27% and 14%–40%, respectively, from T0 to T3; p = 0.02). Planned lifestyle changes increased significantly in patients with class 1 obesity (8% at T0 versus 30% and 40% at T1 and T2; p = 0.02 and p = 0.002), respectively, but not in patients with overweight. Initial increases in the use of aids were not sustained.
Conclusions:
Technological and visual aids, along with PCP training, may support the adoption of standardized provider documentation, assessment, and management of weight-related comorbidities in youth with overweight and obesity in resource-poor settings.
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Supplementary Material
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