Value of measuring waist circumference in primary care: a mixed-methods study

Area of Science:

• Primary Care Research
• Cardiovascular Epidemiology
• Health Services Research

Background:

• General Practitioners (GPs) face challenges in identifying all patients at increased risk of cardiovascular disease (CVD).
• Routine cardiovascular risk assessment for every patient is not feasible in primary care.
• A simple screening tool is needed to identify patients eligible for CVD risk assessment.

Purpose of the Study:

• To evaluate the utility of waist circumference measurement in primary care.
• To investigate current recording practices and identify barriers and facilitators for GPs measuring waist circumference.
• To assess the contribution of waist circumference as a screening tool for increased CVD risk.

Main Methods:

• A mixed-methods study conducted in Dutch primary care.
• Analysis of routine health records from 676,708 adult patients.
• Qualitative data from 21 GPs in 6 focus groups and data from the Netherlands Epidemiology of Obesity (NEO) study (n=6,671).

Main Results:

• GP recording of waist circumference decreased significantly from 2012 to 2023.
• Barriers included GP discomfort, inaccurate measurement, lack of tools, and perceived lack of utility.
• Waist circumference measurement identified 89% of intermediate and 93% of high cardiovascular risk individuals in the NEO study population.

Conclusions:

• Waist circumference measurement shows potential as a screening tool in primary care for cardiovascular risk.
• Addressing GP barriers and promoting facilitators could improve the uptake of waist circumference measurement.
• This simple measurement can aid in identifying a substantial proportion of patients requiring further cardiovascular risk assessment.