• Institute for Clinical Systems Improvement (ICSI). Prevention and management of obesity (mature adolescents and adults). Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2006 Nov. 105 p. [226 references]

Does not apply to this measure

This measure is used to assess the percentage of patients with a documented body mass index (BMI) equal to or greater than 25 who were given education and counsel for weight loss strategies.

The priority aim addressed by this measure is to improve the percentage of patients who have received education and counsel regarding weight loss.

Obesity; education; weight loss strategies (nutrition, physical activity, lifestyle changes, medication, surgery)

Number of patients 18 years of age and older with body mass index (BMI) greater than or equal to 25

Number of patients with a documented body mass index (BMI) greater than or equal to 25 who were given education and counsel for weight loss, which should include: nutrition, physical activity, lifestyle changes, medication and/or surgery

• A clinical practice guideline or other peer-reviewed synthesis of the clinical evidence

Unspecified

Current routine use

Internal quality improvement

Physician Group Practices/Clinics

Physicians

Group Clinical Practices

Age greater than or equal to 18 years

Either male or female

Unspecified

The prevalence of overweight and obese people is increasing worldwide at an alarming rate in both developing and developed countries. Environmental and behavioral changes brought about by economic development, modernization and urbanization have been linked to the rise in global obesity. Obesity is increasing in children and adults, and true health consequences may become fully apparent in the near future.

Obesity has become a national epidemic in the United States (U.S.) with 32% of non-institutionalized adults being obese, and 66.3% being overweight or obese. The most recent data suggest that 17% of adolescents age 12 to 19 years are overweight and an additional 16% are at risk for overweight.

Unspecified

Obesity is the second leading cause of preventable death in United States (U.S.), with only tobacco use causing more deaths. More than 110,000 deaths per year are associated with obesity.

Unspecified

The economic impact of obesity and its related health conditions on the United States (U.S.) economy is staggering and has been estimated at about $118 billion in the late 1990s, or about 12% of the national health care budget, according to the Worldwatch Institute in 2000.

• Institute for Clinical Systems Improvement (ICSI). Prevention and management of obesity (mature adolescents and adults). Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2006 Nov. 105 p. [226 references]

Getting Better
Living with Illness

Effectiveness
Patient-centeredness

Users of care only

Patients with a body mass index (BMI) greater than or equal to 25

If there is no electronic medical record, select 20 patients who have had a visit within the last month who have a BMI greater than or equal to 25. If the BMI is not documented, use the formula: BMI = weight (lbs) x 703 divided by height (inches) squared.

The medical record will be reviewed to determine if one or more of the weight management strategies have been documented. The presence of narrative comments or flow sheets reflecting discussion of one or more of the following weight-management strategies is acceptable evidence for this measure: nutrition, physical activity, lifestyle changes, medication and/or surgery.

If an electronic medical record is available, query data for patients with a visit in the last month with a BMI greater than or equal to 25 (assuming this is a field in the electronic medical record [EMR]).

The medical record will be reviewed to determine if one or more of the weight management strategies have been documented. The presence of narrative comments or flow sheets reflecting discussion of one or more of the following weight management strategies is acceptable evidence for this measure: nutrition, physical activity, lifestyle changes, medication or surgery.

The suggested time period is advice over a 12-month period.

Patients associated with provider

Inclusions
Number of patients 18 years of age and older with body mass index (BMI) greater than or equal to 25

Exclusions
Unspecified

All cases in the denominator are equally eligible to appear in the numerator

Clinical Condition
Encounter

Time window is a fixed period of time

Inclusions
Number of patients with a documented body mass index (BMI) greater than or equal to 25 who were given education and counsel for weight loss, which should include: nutrition, physical activity, lifestyle changes, medication and/or surgery

Exclusions
Unspecified

The measure results are somewhat or substantially under the control of the health care professionals, organizations and/or policymakers to whom the measure applies.

Episode of care

Medical record

Individual Case

Unspecified

Rate

Better quality is associated with a higher score

Unspecified

Internal time comparison

Unspecified

Percentage of patients with a documented BMI equal to or greater than 25 who were given education and counsel for weight loss strategies.

Institute for Clinical Systems Improvement

The following Minnesota health plans provide direct financial support: Blue Cross and Blue Shield of Minnesota, HealthPartners, Medica, Metropolitan Health Plan, PreferredOne, and UCare Minnesota. In-kind support is provided by the Institute for Clinical Systems Improvement's (ICSI) members.

Work Group Members: David Hanekom, MD (Work Group Leader) (MeritCare) (Internal Medicine); Julie Roberts, MS, RD (HealthPartners Medical Group) (Dietitian); Kate Pyzdrowski, MD (NorthPoint Health & Wellness Center) (Endocrinology); Kathryn Nelson, MD (Affiliated Community Medical Center) (Family Practice); Patrick O'Connor, MD (HealthPartners Medical Group) (Family Practice); Andrea Carruthers, RN (Affiliated Community Medical Center) (Nursing); George Biltz, MD (HealthPartners Medical Group) (Pediatrics); Kathy Johnson, PharmD (St. Mary's/Duluth Clinic) (Pharmacy); Nancy Sherwood, PhD (HealthPartners Research Foundation) (Psychology); Walt Medlin, MD (St. Mary's/Duluth Clinic) (Surgery); Penny Fredrickson (Institute for Clinical Systems Improvement) (Measurement/Implementation Advisor); Pam Pietruszewski, MA (Institute for Clinical Systems Improvement) (Facilitator)

Measure was not adapted from another source.

2004 Nov

2006 Nov

Please note: This measure has been updated. The National Quality Measures Clearinghouse is working to update this summary.

• Institute for Clinical Systems Improvement (ICSI). Prevention and management of obesity (mature adolescents and adults). Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2006 Nov. 105 p. [226 references]

This NQMC summary was completed by ECRI on December 20, 2004. This NQMC summary was updated by ECRI on December 15, 2005 and again on January 23, 2007.

This NQMC summary (abstracted Institute for Clinical Systems Improvement [ICSI] Measure) is based on the original measure, which is subject to the measure developer's copyright restrictions.

The abstracted ICSI Measures contained in this Web site may be downloaded by any individual or organization. If the abstracted ICSI Measures are downloaded by an individual, the individual may not distribute copies to third parties.

If the abstracted ICSI Measures are downloaded by an organization, copies may be distributed to the organization's employees but may not be distributed outside of the organization without the prior written consent of the Institute for Clinical Systems Improvement, Inc.

All other copyright rights in the abstracted ICSI Measures are reserved by the Institute for Clinical Systems Improvement, Inc. The Institute for Clinical Systems Improvement, Inc. assumes no liability for any adaptations or revisions or modifications made to the abstracts of the ICSI Measures.