Increasing Screening Rates for Comorbidities in Adolescents with Elevated Body Mass Index in Pediatric Primary Care.

Abstract

Introduction: Adolescents with elevated body mass index are at increased risk for comorbidities such as dyslipidemia, diabetes mellitus, and metabolic dysfunction-associated steatotic liver disease. Guideline-based screening can identify impacted patients early, allowing for lifestyle modifications and other treatments to improve long-term health. Unfortunately, only 20% of pediatric patients with obesity receive recommended screening.

Methods: A multidisciplinary quality improvement team designed and implemented a project to improve comorbidity screening utilizing the Model for Improvement. Provider education and incentive, clinical decision support, and regular performance feedback were chosen as interventions. Screening rates were tracked on a statistical process control chart.

Results: From March through December of 2022, 9547 pediatric patients aged 10 years and up with body mass index greater than or equal to the 95^th percentile were seen for preventive care visits. Screening rates for comorbidities increased from a baseline of 19.5%-58% and were sustained for over 3 months. Numerous patients at risk for chronic disease were identified.

Conclusions: Evidence-based clinical decision support, along with provider education and engagement, can effectively increase screening rates for comorbidities in pediatric patients with obesity.