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Abstract
Aims Childhood obesity is becoming a serious public health challenge of the 21st century in England.
There are well known associated health risks of obesity.
Our local area has high deprivation indices and wide ethnic and cultural diversity.
Our observational study seeks to identify the size of the problem locally, evaluate our practice in recording routine growth parameters and compare results with national data.
Methods Retrospective review of Electronic Patient Records. Data collected included age, self-reported ethnicity and Body Mass Index (BMI). The United Kingdom 1990 growth charts were used to calculate centiles.
The study population was all children ≤ 16 admitted to our 48 h PSSU and children seen in the Rapid Access Clinic (RAC).
Overweight and obese children were defined according to the Scottish Intercollegiate Network’s Guidelines, published in February 2010.
Data was analysed separately for PSSU and RAC.
Results 189 patients admitted to the PSSU within a two-month period were audited. Mean age of 6.2 years. A diverse range of ethnicities were represented (Figure 1).
BMI calculations were available for 40.7% and weight for 79% of our cohort. Our results exceeded the national data available from the Health Survey for England, 2013 (Figure 2).
98 RAC patients were audited within the same period. Mean age of 5 years. Growth measurements were available for 73% of patients (Figure 2).
Comorbidities and specialties involved within PSSU are presented in Figure 3.
PSSU
17 in-patients identified with BMI greater than 98th centile were not seeking any medical intervention. Tailored clinical interventions are recommended for clinically obese children as per 2014 guidelines from the National Institute for Health and Clinical Excellence.
Conclusions The prevalence of overweight and obesity in our local paediatric patients exceeds the national average.
Our recommendations:
To improve compliance with routine growth measurements for all patients, thus improving our ability to identify those at risk.
Signposting high-risk patients to the relevant services by increasing communication with primary care and management within a multidisciplinary team.
Allow opportunistic delivery of public health education at every clinical encounter.
Inform local policy and highlight more directed healthcare within diverse populations.