A new study has found
that many Australian GP’s
do not regularly calculate Body Mass Index (BMI) in children, and when
they do measure height and weight often the equipment is imprecise and
therefore their assessment is inaccurate.
The study by researcher Ms
Bibi Gerner and colleagues from the Murdoch Childrens Research Institute’s
Centre for Community Child Health, at Melbourne’s Royal Children’s
Hospital, is in the latest edition of the Journal of Paediatrics and
Child Health (JPCH), the peer reviewed journal of the Paediatrics Division
of The Royal Australasian College of Physicians (RACP).
“ We found that current practice by general practitioners
falls well short of the 2003 National Health and Medical Research Council
guidelines
recommending bi-annual measuring of all children in the primary care
setting. We also found variability of equipment used to measure height
(stadiometers) and weight (scales) which could lead to serious misclassification
of many children’s weight status,” Ms Gerner said.
Thirty-four general practitioners from 29 primary care family medical
practices in Melbourne were involved in the study. The GP’s completed
a questionnaire regarding their routine practice for 5–10 year
old children and perceived role in managing childhood overweight and
obesity. Practice audits in 2002 assessed the accuracy and accessibility
of equipment.
“ The study found only 44% of GP’s regularly weighed children
and only 38% regularly measured children. Only one of the GP’s
regularly calculated children’s BMI. Equipment to measure height
undermeasured slightly. Scales were less accurate and on average weights
of 20kg and 80kg were recorded as 19.7kg and 79.2kg respectively,” Ms
Gerner said.
Despite these shortcomings, general practitioners generally felt they
played a key role in managing overweight in children. Most participants
said they felt very or quite comfortable (80%) and competent (71%) broaching
the issue of a child’s weight, and very or quite comfortable (97%)
and competent (88%) discussing the child’s weight.
“ The current system assumes that general practitioners routinely
weigh and measure children, that their equipment is accessible and accurate,
and that they can and do calculate and interpret BMI. Unfortunately,
we discovered this is not the case, and very few children are regularly
measured against the BMI standards.”
The inaccuracy of the equipment audited across these practices could
result in misclassification of a child’s weight status and possibly
to inappropriate weight management advice. The results suggest it may
be advisable to develop national guidelines regarding specifications
and maintenance of equipment in doctors’ surgeries, over and
above the current national standards which simply specify that all
general practices should be equipped with “scales” and “height
measurement devices”.
“ Whilst the 2003 NHMRC recommendations may have lead to improved
assessment for overweight children since this study, our results suggest
it would take a large practice shift to meet current recommendations.
We conclude that considerable research and translation efforts are needed
to support general practitioners in the effective identification and
management of child overweight and obesity,” Ms Gerner said.
The RACP is responsible for training, educating and representing over
9,000 physicians in Australia and New Zealand. The RACP represents 25
medical sub-specialties including paediatrics, public health and occupational
medicine. Physicians are often called specialists and are doctors who
have completed an extra six years or more of training after their initial
medical training and choose to specialise in a particular area of medicine.
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those of IvyRose Ltd.. Material in this news item was released
by the Royal Australasian College of Physicians,
on 3 April 2006.
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