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Diagnosis and Management of Childhood Obesity in a Canadian Academic Family Medicine Teaching Unit
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  • Jean-Sebastien Paquette,
  • Laurence Théoret,
  • Laurence Veilleux,
  • Johann Graham,
  • Marie-Pier Paradis,
  • Nathalie Chamberland,
  • Gabrielle Lanctot,
  • Pascale Breault,
  • Mathieu Pelletier,
  • Samuel Boudreault
Jean-Sebastien Paquette
Laval University Faculty of Medicine

Corresponding Author:[email protected]

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Laurence Théoret
Laval University Faculty of Medicine
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Laurence Veilleux
Laval University Faculty of Medicine
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Johann Graham
Laval University Faculty of Medicine
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Marie-Pier Paradis
Laval University Faculty of Medicine
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Nathalie Chamberland
Laval University Faculty of Medicine
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Gabrielle Lanctot
Laval University Faculty of Medicine
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Pascale Breault
Laval University Faculty of Medicine
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Mathieu Pelletier
Laval University Faculty of Medicine
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Samuel Boudreault
Laval University Faculty of Medicine
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Abstract

Rationale: The aim of this study was to use the clinical practice guidelines issued by the Quebec provincial government to assess the diagnosis and management of childhood obesity in a Canadian academic family medicine teaching unit (FMTU). Methods: We performed an audit of diagnosis and care of childhood obesity in a FMTU in the province of Quebec. We used the clinical practice guidelines established by the Quebec government’s Institut national d’excellence en santé et en services sociaux (INESSS) which include use of the World Health Organization (WHO) growth chart for diagnosing childhood obesity. We analyzed the electronic medical records of every child from 5 to 12 years old who had a medical appointment at the FMTU in 2017 (n=618). We audited whether childhood obesity had been correctly diagnosed according to the WHO growth chart and if the medical care that followed was adequate according to INESSS guidelines. Results: We identified 71 children as obese according to the WHO chart, of whom 40 (56%) had been diagnosed as such by clinic health professionals. Of these 40, (33) 83% received nutritional counseling, (33) 83% received physical activity counseling, (13) 33% had parent’s involvement counselling, (19) 48% were referred to another health professional (e.g., dietician, psychologist, kinesiologist) and (12) 31% were followed up within six months. Only 7 (18%) patients received all INESSS’s recommendations. Conclusions: Our study shows that childhood obesity remains under-diagnosed in Canadian primary care, even in an academic teaching environment. This affects the quality of care delivered to these patients. Moreover, even if childhood obesity had been correctly diagnosed, management of this clinical condition is still incomplete. Understanding barriers and facilitators to diagnosing and managing childhood obesity is necessary to improve the quality of care on a larger scale.