General practice consultations with obese children–a missed opportunity? Cross-sectional study using linked national child measurement and primary care data

Abstract

BackgroundA third of children leaving primary school are obese. Child weight status information from the National Child Measurement Programme (NCMP) is not routinely shared with general practitioners (GPs). We hypothesised that obese children were more likely to consult their GP for obesity or weight management than healthy-weight children. MethodsNCMP data from 2013–16 for City and Hackney, London, were linked to coded GP data using pseudonymised National Health Service numbers, resulting in 13 663 linked records (93%). NCMP-assigned weight status was based on the UK90 clinical reference, and obesity and weight-management consultations identified (read codes C38..; 66C..; 8HHH%; 9N1yK; 22A%). The odds of one or more obesity or weight-management consultations in the school year of NCMP measurement among obese compared with healthy-weight children were estimated with logistic regression. FindingsObesity was identified in 624 (8·6%) of 7275 children aged 5 years (3721 boys [51·2%]; median age 5·01 years, IQR 4·76–5·27) and 1220 (19·1%) of 6388 children aged 11 (3297 [51·6%]; 10·87, 10·59–11·11). Obesity was more prevalent in boys than girls (9·5% [353/3721] vs 7·6% [271/3554] and 19·5% [643/3297] vs 18·7% [577/3091] at ages 5 and 11 years, respectively). Obese children were more likely than healthy-weight children to consult for obesity or weight management (respectively at age 5 years, boys 19·8% [70/353] vs 13·5% [391/2900]; girls 16·2% [44/271] vs 11·8% [342/2895] and at age 11 years, boys 17·0% [109/643] vs 12·6% [265/2111]; girls 19·9% [115/577] vs 10·0% [200/1996]). The odds of one or more obesity or weight-management consultations in obese boys and girls, respectively, were 1·59 (95% CI 1·20–2·10) and 1·45 (1·03–2·04) at age 5 years, and 1·42 (1·12–1·81) and 2·24 (1·74–2·87) at age 11 years. InterpretationAlthough more likely to consult their GP for obesity or weight management in the period before or after identification of obesity in the NCMP, fewer than a fifth of obese children attending primary schools in a London borough with one of the highest child obesity rates in England do so. This is, to our knowledge, the first study linking NCMP to primary care data. Further work is needed to evaluate routine sharing of NCMP data with GPs and primary care-initiated weight-management support for children and their families. FundingNone.