CANadian Pediatric Weight management Registry CANPWR. UPDATE ON PROGRESS CANNeCTIN Meeting 27.April.2010

Transcription

1 CANadian Pediatric Weight management Registry CANPWR UPDATE ON PROGRESS CANNeCTIN Meeting 27.April.2010

2 KM Morrison Hamilton (PI) Geoff Ball Edmonton, AB JP Chanoine Vancouver, BC Mark Tremblay Ottawa, ON Stasia Hadjiyannakis Ottawa, ON T R O P I C Marie Lambert Montreal, Quebec CANPWR Investigators

3 Childhood Obesity treatment Healthy Balanced Nutrition SURGERY Regular physical activity Family based behavioural therapy Pharmacotherapy

4 Intervening in childhood obesity metaanalyses 64 RCTs 5230 participants Meta-analysis results: reduction in overweight at 6 and 12 months with: - Lifestyle modification in children - Lifestyle modification in adolescents +/- meds CONCLUSION: combined behavioural lifestyle interventions compared to standard care or self-help can produce a significant and clinically meaningful reduction in overweight in children and adolescents :

5 Children with CV risk factors are more likely to have heart attacks and strokes as adults Cardiovascular event rate by age according to CV risk factors at age 6-19 % FOLD RISK 19.4% * obesity blood pressure glucose triglycerides HDL-cholesterol % < 3 at least 3 # risk factors* at age 6-19 y/o Morrison et al. Pediatrics :340

6 Establishment of Canadian registry of children and youth attending weight management programs OBJECTIVES: Investigate health outcomes at baseline Investigate the environmental, biological and social determinants for the development of adverse health outcomes (metabolic, psychosocial, other) in overweight and obese youth Investigate health outcomes in a longitudinal manner, identify and compare changes in health outcomes between weight management program types Develop a platform for research programs

7 Development of obesity treatment registry 2 PHASES were described: PHASE 1: Identify core metrics for assessment of adiposity and the determinants and health consequences of obesity in childhood and adolescence at baseline and at clinical follow-up. PHASE 2: Establish a registry of Canadian youth and their families attending weight management programs.

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9 Population of overweight Canadian children Referral to care any level REGISTRY PROPOSED MEASURES SES Physical activity Anthropometry (eg BMI, WC, Body fat) Ethnicity Physical fitness Blood pressure Age, Gender Nutritional intake Glycemia Postal Code Immigrant status Lipoproteins lipids, apoproteins Health related quality of life Family health history Other psychosocial Data collection framework Weight management program type Adherence, treatment modalities Clinic visits, electronic or telephone F/U Yearly re-assessment of outcomes

10 Establishment of Canadian registry of children and youth attending weight management programs PILOT Questions: What proportion of children and youth enrolling in established clinical weight management programs will consent to participate in the registry? How prevalent are obesity-related metabolic and psychosocial comorbidities in Canadian youth presenting for assistance with weight management to tertiary care centres? How do these children compare to a representative sample of non-obese children and youth in Canada currently being examined in the Canadian Health Measures Survey (CHMS)? How complete is data collected within a clinical care setting at baseline and during follow-up?

11 Pilot Proposal Quick Facts Funded by CANNeCTIN commenced September 2009 Timeline as follows: Sep-09 Dec-09 Mar-10 Jun-10 Sep-10 Dec-10 Mar-11 Jun-11 Establishment of metrics CRF Development Database development Recruitment phase 5 sites Metrics for pilot nearing completion and CRF to be finalized by May 2010 Ethics application submitted at McMaster / HHS (March 2010)

12 Pilot Proposal Next steps Finalize protocol, CRFs and submit to ethics at other sites Hiring and training of site personnel with DATAFAX Site training visits Commence recruitment Continue monthly teleconferences Develop plans for expansion to full scale registry planned grant submission Fall Next meeting at Canadian Childhood ObesityUpdate, Hamilton, ON October28-30, 2010.

13 QUESTIONS / DISCUSSION?