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. This study was published in the January issue of Pediatrics.
More than one-third of children in the U.S. are now overweight or obese, according to study, who added that despite the statistics, childhood obesity remains under-recognized and undertreated. They added that health IT may improve the quality, efficiency and reach of chronic disease management.
To assess this hypothesis, Anna Jo Smith, MPH, MSc, of the department of non-communicable disease epidemiology at the London School of Hygiene and Tropical Medicine in London and Harvard Medical School in Boston, and colleagues sought to review the effect of health IT (EHRs, telemedicine, text message or telephone support) on patient outcomes and care processes in pediatric obesity management.
The researchers evaluated Medline, Embase, and the Cochrane Registry of Controlled Trials from January 2006 to April 2012. They included controlled trials, before-and-after studies and cross-sectional studies if they used IT to deliver obesity screening or treatment to children aged two to 18, and if the trials reported impact on patient outcomes (body mass index [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.
Thirteen studies met inclusion criteria.
Smith and colleagues reported that EHR use was associated with increased BMI screening rates in five of eight studies. Telemedicine counseling was associated with changes in BMI percentile similar to that of in-person counseling and improved treatment access in two studies. Text message or telephone support was associated with weight loss maintenance in one of three studies.
With the text message or telephone-based support, the authors suggested that greater frequency of contact may increase impact. However, as some contact is patient initiated, this association may be non-causal and reflect differential patient motivation, they wrote.
“More interactive and time-intensive interventions may enhance health IT’s clinical effectiveness in chronic disease management,” concluded the authors.