Adult Weight Screening and Follow-Up (NQF 0421)

EMeasure Name Adult Weight Screening and Follow-Up EMeasure Id 0beb4703-3e00-4964-be02-40a7ecbf32c9
Version number 1 Set Id aa066eed-e8f6-4fec-8084-61d3d1e8b6e2
Available Date No information Measurement Period January 1, 20xx through December 31, 20xx
Measure Steward Quality Insights of Pennsylvania
Endorsed by National Quality Forum
Description Percentage of patients aged 18 years and older with a calculated BMI in the past six months or during the current visit documented in the medical record AND if the most recent BMI is outside parameters, a follow-up plan is documented.
Copyright
Measure scoring Proportion
Measure type Process
Stratification
Stratified by (i) age: >=65,  (ii) age >=18 and <=64
Risk Adjustment
None
Data Aggregation
Rationale
Of the Medicare population, 37 percent are overweight, and 18 percent are obese. Between 1991 and 1998, the prevalence of obesity among persons age 60-69 increased by 45 percent (American Obesity Association).

According to a 1998 survey, only 52 percent of adults age 50 or older reported being asked during routine medical check-ups about physical activity or exercise. The likelihood of being asked about exercise during a routine check-up declined with age (Center for the Advancement of Health, 2004).

Elderly patients with unintentional weight loss are at higher risk for infection, depression and death. In one study it was found that a BMI of less than 22 kg per m2 in women and less than 23.5 in men is associated with increased mortality. In another study it was found that the optimal BMI in the elderly is 24 to 29 kg per m2. (Huffman, G. B., Evaluation and Treatment of Unintentional Weight Loss in the Elderly, American Family Physician, 2002 Feb, 4:640-650.)
			
Clinical Recommendation Statement
The USPSTF (2009) recommends that clinicians screen all adult patients for obesity and offer intensive counseling and behavioral interventions to promote sustained weight loss for obese adults. (Level of Evidence = B, USPSTF)

The clinical guideline for obesity recommends assessment of BMI at each encounter (National Heart, Lung and Blood Institute).

Management of Obesity indicates that the body mass index should be calculated at least annually for screening and as needed for management (The Institute for Clinical Systems Improvements 2009 Guideline for Prevention and Management of Obesity).

Validated measure of nutrition status serves as an indicator of over-nourishment and under-nourishment. Nutrition Screening Initiative: Nutrition Interventions Manual for Professionals Caring for Older Americans, 2002 (Co-sponsored by American Dietetic Association (ADA), AAFP and National Council on Aging, Inc.).

The NSI-suggested BMI range is 22-27 (values outside this range indicate overweight or underweight for elderly) Nutrition Screening Initiative: Nutrition Interventions Manual for Professionals Caring for Older Americans, 2002 (Co-sponsored by American Dietetic Association (ADA), AAFP and National Council on Aging, Inc.).
			
Improvement notation
Higher score indicates better quality
Measurement duration
12 month(s)
Reference
Definition
Guidance

Table of Contents


Population criteria

      ------ Population Criteria 1 ------

      ------ Population Criteria 2 ------

Data criteria (QDS Data Elements)

Summary Calculation

Calculation is generic to all measures:



Measure set CLINICAL QUALITY MEASURE SET 2011-2012