ESPE Abstracts

Introduction: The substantial increase in prevalence of childhood obesity presents a major challenge. Obesity is associated with significant physical and mental co-morbidities including diabetes and cardiovascular disease. Successful treatment requires intensive input from a specialist multidisciplinary team. In 2019, NHS England initiated a pilot to treat Complications Relating to Excess Weight (CEW) in dedicated clinics across the country. Facilitating sufficient face to face clinical appointments in the face of increased need for services carries associated costs and greater demand, both on the patient and their families, and on the medical team. To supplement the regular clinical encounters, a digital support system (Evira) designed for daily home weight measurements was introduced into the treatment pathway to provide consistent input from the multidisciplinary team whilst reducing the need for physical visits.

Methods: Patients seen in the Alder Hey CEW clinic between January and May 2024 were offered the opportunity to use the custom-made digitless measuring device as part of their treatment pathway. The device transfers the measurements via Bluetooth to a mobile application and presents BMI Z-scores graphically with an individualised weight loss target curve. In addition, the data is transferred to a web-based clinic interface that enables the clinic to monitor patient progress as they receive additional input from the multidisciplinary team, and to provide regular contact between the clinical staff and families through the application’s communication system.

Results: An initial cohort of 19 patients, including both new and existing patients, were enrolled into the device after discussion and consent from the patient and their families. The average age was 12.5 years (range 7.8-16.6 years) with 68% male. The average BMI standard deviation score (SDS) at the start of treatment was +3.86, with a mean change in BMI SDS in the first month of use -0.043, and a further mean change of -0.012 SDS in the second month. During the first month, 100% of patients recorded at least one measurement, with 95% recording at least one during the second month, and on average patients recorded measurements on 3.8 days per week.

Conclusions: Use of regular home measurements alongside a standard treatment pathway can promote greater autonomy amongst the patient population regarding positive changes by providing graphical representation of their progress. Additionally, with continuous data provided to the clinic, adherence to treatment can be tracked and supported on a regular basis especially between clinic appointments.