TY - JOUR
T1 - Health information technology in screening and treatment of child obesity
T2 - A systematic review
AU - Smith, Anna Jo
AU - Skow, Áine
AU - Bodurtha, Joann
AU - Kinra, Sanjay
PY - 2013/3
Y1 - 2013/3
N2 - BACKGROUND AND OBJECTIVES: Childhood obesity is a major problem in the United States, yet screening and treatment are often inaccessible or ineffective. Health information technology (IT) may improve the quality, efficiency, and reach of chronic disease management. The objective of this study was to review the effect of health IT (electronic health records [EHRs], telemedicine, text message or telephone support) on patient outcomes and care processes in pediatric obesity management. METHODS: Medline, Embase, and the Cochrane Registry of Controlled Trials were searched from January 2006 to April 2012. Controlled trials, before-and-after studies, and cross-sectional studies were included if they used IT to deliver obesity screening or treatment to children aged 2 to 18 and reported impact on patient outcomes (BMI, dietary or physical activity behavior change) or care processes (BMI screening, comorbidity testing, diet, or physical activity counseling). Two independent reviewers extracted data and assessed trial quality. RESULTS: Thirteen studies met inclusion criteria. EHR use was associated with increased BMI screening rates in 5 of 8 studies. Telemedicine counseling was associated with changes in BMI percentile similar to that of in-person counseling and improved treatment access in 2 studies. Text message or telephone support was associated with weight loss maintenance in 1 of 3 studies. CONCLUSIONS: To date, health IT interventions have improved access to obesity treatment and rates of screening. However, the impact on weight loss and other health outcomes remains understudied and inconsistent. More interactive and time-intensive interventions may enhance health IT's clinical effectiveness in chronic disease management.
AB - BACKGROUND AND OBJECTIVES: Childhood obesity is a major problem in the United States, yet screening and treatment are often inaccessible or ineffective. Health information technology (IT) may improve the quality, efficiency, and reach of chronic disease management. The objective of this study was to review the effect of health IT (electronic health records [EHRs], telemedicine, text message or telephone support) on patient outcomes and care processes in pediatric obesity management. METHODS: Medline, Embase, and the Cochrane Registry of Controlled Trials were searched from January 2006 to April 2012. Controlled trials, before-and-after studies, and cross-sectional studies were included if they used IT to deliver obesity screening or treatment to children aged 2 to 18 and reported impact on patient outcomes (BMI, dietary or physical activity behavior change) or care processes (BMI screening, comorbidity testing, diet, or physical activity counseling). Two independent reviewers extracted data and assessed trial quality. RESULTS: Thirteen studies met inclusion criteria. EHR use was associated with increased BMI screening rates in 5 of 8 studies. Telemedicine counseling was associated with changes in BMI percentile similar to that of in-person counseling and improved treatment access in 2 studies. Text message or telephone support was associated with weight loss maintenance in 1 of 3 studies. CONCLUSIONS: To date, health IT interventions have improved access to obesity treatment and rates of screening. However, the impact on weight loss and other health outcomes remains understudied and inconsistent. More interactive and time-intensive interventions may enhance health IT's clinical effectiveness in chronic disease management.
KW - BMI
KW - Child
KW - Decision support systems
KW - Electronic health records
KW - Information technology
KW - Obesity
KW - Review
KW - Telemedicine
KW - Text messaging
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UR - http://www.scopus.com/inward/citedby.url?scp=84874641594&partnerID=8YFLogxK
U2 - 10.1542/peds.2012-2011
DO - 10.1542/peds.2012-2011
M3 - Review article
C2 - 23382447
AN - SCOPUS:84874641594
VL - 131
SP - e894-e902
JO - Pediatrics
JF - Pediatrics
SN - 0031-4005
IS - 3
ER -