G225(P) How should we approach obesity in the Emergency Department?

Introduction Approximately 3 in 10 children aged 2–15 years in the UK are overweight or obese.1 NICE guidance states that “Health professionals should tell the parents of children…about local lifestyle weight management programmes.” The purpose of this project is to better understand how overweight and obese children can be identified and managed following presentation to the paediatric emergency department in Northern Ireland. Aims Audit existing practice Compile a list of available weight management programmes Work with parents to improve the service Work with health professionals to improve the service Methods Existing practice was audited retrospectively by reviewing 100 case notes selected randomly over 12 months. Weight and demographic data were recorded, as was any intervention. Barriers to care in the department were explored through the use of focus groups. A review of existing lifestyle and weight management programs was conducted by: Contacting public health Northern Ireland, Searching district council websites Questioning clinicians Parent involvement was encouraged through a questionnaire. This collected data on; attitudes towards obesity, how best to discuss the topic and on what services parents want access to. Results No patients had weight issues discussed. There are no endorsed or well recognised obesity services for children in Northern Ireland Health professionals felt uncomfortable discussing obesity and those that did discuss the issue felt the lack of available lifestyle and weight management services undermined any discussion they had. 51 questionnaires were returned by parents. 98% felt that obesity was an important health issue with 84% stating that overweight or obese children should be identified in the emergency department. Our parents told us that 77% of them would want to be referred on to a dietetic or weight loss service. Conclusion Parents are worried about obesity and the vast majority would like to be told (even if it is in the emergency department). Health professionals however, find it difficult discussing weight issues when they know there are no community services to refer to. There is an urgent need for community obesity services for children in Northern Ireland.