Pediatric Rules and Reminders

 

Obesity, (BMI > 95%), Overdue for weight check

 

 

Clinician Summary
The 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. High Risk individuals are defined 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 check the weight of individuals who have  the following recorded indicators within the electronic health record (EHR) system:

·         Age ≥ 10 yrs and ≤ 18 yrs; and

·         BMI > 95%; and

·         most recent BMI > 6 months ago

 

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 Vol. 112 No. 2 August 2003, pp. 424-430.

3.   Obesity Evaluation and Treatment: Expert Committee Recommendations PEDIATRICS Vol. 102 No. 3 September 1998, p.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/pdfs/Health_Promotion_Information_Sheets/healthyweight.pdf


 

Implementation Notes

 

Rule category

Obesity

Rule title

Obesity ages ≥ 10 BMI > 95% due for weight check

Primary Clinical Area

Pediatrics

Secondary Clinical Area

 

Risk Group Definition

age ≥ 10 yrs and ≤18 yrs and BMI >95%

Details for Risk Group

BMI% calculated flowsheet

Triggering Condition

Most recent BMI >6 months ago

Details for Triggering

N/A

Condition

 

Displayed Message

Patient’s BMI >95%. Consider exercise/nutrition counseling and monitoring weight every 3 to 6 months.

Coded Responses

Snooze Periods

 A:  Done/Scheduled today

B: Appointment scheduled

C: Patient Refuses

D: Deferred

E: Other

F:

G:

H:

 

 A': 6 months

B': 6 months

C': 3 months

D': 3 months

E': 1 month

F':

G':

H':

 


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.