A project to improve the quality of care for overweight and obese patients in a Nelson general practice
Jennifer Naper 1 , Luis Manetto 2 , Diane Wiren 21 Nelson Marlborough District Health Board, Nelson, New Zealand
2 Nelson Medical and Injury Centre, Nelson, New Zealand
Correspondence to: Jennifer Naper, Nelson Marlborough District Health Board, Nelson, New Zealand. Email: jennaper86@gmail.com
Journal of Primary Health Care 9(4) 321-327 https://doi.org/10.1071/HC17009
Published: 12 December 2017
Journal Compilation © Royal New Zealand College of General Practitioners 2017.
This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Abstract
INTRODUCTION: Local guidelines exist in Nelson to assist general practitioners (GPs) in supporting overweight and obese patients with weight loss and improvements in their overall health. This audit measures whether this role is fulfilled in a Very Low Cost Access practice in Nelson, in which 76% of enrolled patients reside in New Zealand social deprivation index quintiles 4 and 5.
AIM: This study measured whether Nelson Marlborough District Health Board Health Pathways and the Ministry of Health Clinical Guidelines are followed in identifying risk and initiating management, including treatment of additional risk factors, lifestyle modification and dietitian referral.
RESULTS: Although limited by sample size and consecutive patient screening methodology, the results of this study indicate that overweight and obesity rates in this practice are comparable with the national average, with Māori and Pacific Island populations more likely to be affected compared to their New Zealand European counterparts. Of the patients who had their body mass index recorded, 65% were overweight or obese. Risk factors were assessed and treated in all, green prescriptions were issued in 4%, and 23% were referred to a dietitian.
DISCUSSION: Audit findings were presented at an intervention session where strategies for improvement were considered including routine waist circumference measurement, dietitian referral, exercise on prescription and providing individualised tailored approaches that integrate patients’ cultural and social context. While risk factors are being managed appropriately, improvements can be made in identifying high-risk patients, promoting lifestyle modifications and early dietitian referral.
KEYWORDS: Obesity; general practitioner; cardiovascular risk factors; exercise; weight management
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