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Obesity

Emergency department referrals

Phone on call Diabetic and Endocrinology Registrar via:

  • Royal Brisbane & Women’s Hospital switch - (07) 3646 8111
  • The Prince Charles Hospital switch - (07) 3139 4000
  • Redcliffe Hospital switch – (07) 3883 7777
  • Caboolture Hospital switch – (07) 5433 8888

 

and send patient to the Department of Emergency Medicine (DEM) at their nearest hospital.

Does your patient wish to be referred?

Minimum referral criteria

Does your patient meet the minimum referral criteria?

Category 1

Appointment within 30 days is desirable

  • Patients with a serious obesity-related comorbidity^ that is likely to deteriorate quickly, if urgent weight loss is not achieved
  • Patients requiring urgent lifesaving operation/procedure that requires immediate weight loss for surgery/procedure to proceed (e.g. organ transplantation or assessment for organ transplantation, angiogram or cardiac surgery)
  • ^Serious obesity related comorbidities include (not an exhaustive list):
    • severe liver disease with potential treatment
    • severe pulmonary hypertension
    • recurrent venous thromboembolism
    • benign intracranial hypertension

Category 2

Appointment within 90 days is desirable

  • Patients with severe obesity-related comorbidities such as (not an exhaustive list):
    • nephrotic range proteinuria or rapidly progressing renal impairment
    • chronic respiratory failure or obesity hypoventilation syndrome
    • severe OSA
    • recurrent cellulitis or venous ulcerations
    • recurrent hospital admission for an obesity related condition
    • patients requiring weight loss for a semi-urgent or elective operation/procedure
    • poorly controlled diabetes with HbA1c > 9% with BMI >50
    • Patients with Prader Willi Syndrome  (PWS) unless meet the criteria for Cat 1

Category 3

Appointment within 365 days is desirable

  • BMI >55 younger age i.e. 18-55 without co-morbidities listed in Cat 1 or 2

If your patient does not meet the minimum referral criteria

Consider other treatment pathways or an alternative diagnosis.

If you still need to refer your patient:

  • Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
  • Please note that your referral may not be accepted or may be redirected to another service

Other important information for referring practitioners

Not an exhaustive list

  • Measure waist circumference in addition to calculating BMI  if BMI <40
  • Lifestyle modification (increased activity, dietary, weight, smoking, alcohol)
  • Convey the message that even small amounts of weight loss may improve health and wellbeing
  • Use multicomponent approaches — these work better than single interventions
  • Refer appropriately to assist people to make lifestyle changes or for further intervention
  • Support a self-management approach and provide ongoing monitoring
  • Manage comorbidities when they are identified; do not wait until the person has lost weight
  • Offer people who are not yet ready to change the chance to return for further consultations when they are ready to discuss their weight again and willing or able to make lifestyle changes
  • Assess the person’s readiness to adopt changes and person’s confidence in making changes
  • Alternative services

Referral requirements

A referral may be rejected without the following information.

Essential Referral Information

  • General referral information
  • Height, weight, BMI
  • Summary of weight loss initiatives taken by patient and health care provider prior to referral
  • Details of any allied health support in place to assist with weight loss (any GPMP/TCA in place)
  • Ensure all comorbidities clearly stated
  • Current medications list
  • Details of all treatments offered and efficacy
  • Fasting lipids results
  • FBC, HbA1c, urinary albumin ratio
  • TSH, ELFTs results

Additional Referral Information (Useful for processing the referral)

  • Advise any risk factors assessed using lipid profile (preferable fasting), BP and HbA1c measurement
  • The person’s lifestyle (diet and physical activity) and eating behaviour and/or any underlying causes for being overweight or obese

Out of catchment

Metro North Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service. If your patient lives outside the Metro North Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.

  • Impact on employment
  • Impact on education
  • Impact on home
  • Impact on activities of daily living
  • Impact on ability to care for others
  • Impact on personal frailty or safety
  • Identifies as Aboriginal and/or Torres Strait Islander

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can’t order, or the patient can’t afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

  • Presenting symptoms (evolution and duration)
  • Physical findings
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
  • Body mass index (BMI)
  • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
  • Current medications and dosages
  • Drug allergies
  • Alcohol, tobacco and other drugs use

  • Full name (including aliases)
  • Date of birth
  • Residential and postal address
  • Telephone contact number/s – home, mobile and alternative
  • Medicare number (where eligible)
  • Name of the parent or caregiver (if appropriate)
  • Preferred language and interpreter requirements
  • Identifies as Aboriginal and/or Torres Strait Islander

  • Full name
  • Full address
  • Contact details – telephone, fax, email
  • Provider number
  • Date of referral
  • Signature

  • Willingness to have surgery (where surgery is a likely intervention)
  • Choice to be treated as a public or private patient
  • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)
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