Rutha Chivate, Pamela Schoemer, Maya I. Ragavan, Kristin Ray, Megan O. Bensignor, Andrea B. Goldschmidt, Mary Ellen Vajravelu
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引用次数: 0
Abstract
Background
Recent pediatric guidelines recommend clinicians offer anti-obesity medication (AOM) as an adjunct to intensive lifestyle intervention.
Objective
To investigate pediatricians' perspectives about prescribing AOM, including barriers and facilitators.
Methods
An investigator-developed survey was emailed to primary care pediatric physicians (n = 187) and advanced practice providers (n = 190) within an academic-affiliated network. The survey evaluated how willing clinicians were to prescribe AOM and their agreement with 25 statements about barriers and facilitators. Three vignettes explored AOM decision-making. Multinomial logistic regression was used to determine relative risk ratios for willingness to prescribe by agreement with each statement.
Results
Among 74 respondents (20% response rate), 24% were willing, 42% uncertain and 34% unwilling to prescribe. Most (64%) agreed that AOM should be managed only by specialists. Willingness to prescribe was associated with clinician motivation and belief in guideline practicality and applicability. Unwillingness was associated with beliefs that patients would not continue AOM long enough for benefit and that there was insufficient time or resources to implement. In vignettes, 52% were willing to prescribe AOM for a patient with severe obesity and metabolic complications, versus 11% for a patient with obesity and possible disordered eating.
Conclusions
Willingness to prescribe AOM was low and was associated with perceived practicality and appropriateness for patients.
期刊介绍：
Pediatric Obesity is a peer-reviewed, monthly journal devoted to research into obesity during childhood and adolescence. The topic is currently at the centre of intense interest in the scientific community, and is of increasing concern to health policy-makers and the public at large.
Pediatric Obesity has established itself as the leading journal for high quality papers in this field, including, but not limited to, the following:
Genetic, molecular, biochemical and physiological aspects of obesity – basic, applied and clinical studies relating to mechanisms of the development of obesity throughout the life course and the consequent effects of obesity on health outcomes
Metabolic consequences of child and adolescent obesity
Epidemiological and population-based studies of child and adolescent overweight and obesity
Measurement and diagnostic issues in assessing child and adolescent adiposity, physical activity and nutrition
Clinical management of children and adolescents with obesity including studies of treatment and prevention
Co-morbidities linked to child and adolescent obesity – mechanisms, assessment, and treatment
Life-cycle factors eg familial, intrauterine and developmental aspects of child and adolescent obesity
Nutrition security and the "double burden" of obesity and malnutrition
Health promotion strategies around the issues of obesity, nutrition and physical activity in children and adolescents
Community and public health measures to prevent overweight and obesity in children and adolescents.
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