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Obesity, (BMI>95%), Overdue for lipid profile
Clinician
Summary
The
American Diabetes Association (ADA) consensus panel recommends that
overweight individuals (BMI >85%) at high risk for developing Type II
Diabetes should be screened starting at age 10, or at onset of puberty if it
occurs earlier. Individuals are
defined as being at High Risk based on family history of Type II diabetes,
race/ethnicity, signs of or conditions associated with insulin resistance
(acanthosis nigricans, HTN, dyslipidemia, PCOS).
This reminder prompts clinicians to screen High Risk individuals who have the following recorded indicators within
the electronic health record (EHR) system:
- 10 ≥ Age ≤ 18; and
- BMI>95% at least once within the last 24 months; and
- most recent LDL is older than 24 months; and
- most recent total cholesterol is older than 24 months; and
- patient has a recorded height and weight within the last 24
months
References
1. Type 2 diabetes in children and adolescents. American
Diabetes Association. Diabetes Care. 2000 Mar;23(3):381-9.
2. Prevention of Pediatric Overweight and Obesity.
Pediatrics. 2003 Aug;112(2):424-430.
3. Obesity Evaluation and Treatment: Expert Committee
Recommendations. Pediatrics. 1998 Sep;102(3):e29.
Web Links
1. American Academy of Pediatrics
http://aappolicy.aappublications.org/cgi/content/full/pediatrics;112/2/424
2. Bright Futures
http://brightfutures.aap.org/web/healthCareProfessionalstoolsAndResources.asp
Implementation
Notes
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Rule
category
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Obesity
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Rule
title
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Obesity,
high BMI, Overdue for lipid profile
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Primary
Clinical Area
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Pediatrics
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Secondary
Clinical Area
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Risk
Group Definition
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age
≥ 10 yrs AND age ≤18 yrs and BMI >95%
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Details
for Risk Group
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BMI
% calculated flowsheet
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Triggering
Condition
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Most
recent total cholesterol ≥ 24 months and most recent LDL ≥ 24
months and last record of BMI < 24 months
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Details
for Triggering
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LDL,
total cholesterol, For BMI, the most recent height and weight must be
within the past 24 months.
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Condition
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If
either height or weight is more than 24 months old, patient does not belong
to this risk group.
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Displayed
Message
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Patient’s
BMI >95%. Consider lipid profile every 1 to 2 years.
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Coded
Responses
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Snooze
Periods
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A:
Done/Scheduled
B: Patient
Refuses
C: Deferred
D: Other
E: Done
elsewhere
F:
G:
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A':
2 years
B': 6 months
C': 3 months
D': 1 month
E': 2 years
F':
G':
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Disclaimer
These rules
and/or reminders were created using national, state and local guidelines, and
group consensus regarding best practices. These guidelines, and their
interpretation by clinicians at Partners Healthcare System, may not represent
the standard of care across all regions or settings, and are not intended to
be adopted or applied without independent assessment of their suitability for
a particular setting. Moreover, guidelines change over time (for example, the
age range for children who should receive influenza vaccinations was recently
extended to 59 months). The rules and/or reminders may need the addition or
modification of certain items to ensure that they remain consistent with
current guidelines. Therefore, the rules and/or reminders included here are
intended only as examples or guides for the development of similar rules and/or
reminders in other settings. Partners Healthcare System and its affiliates
disclaim any and all responsibility or liability associated with the use of
the rules and/or reminders displayed here by third parties.
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