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://pediatrics.aappublications.org/content/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.