基层医疗机构对为青少年开具抗肥胖药物的看法。

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity Pub Date : 2024-06-16 DOI:10.1111/ijpo.13146

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

摘要

背景：最近的儿科指南建议临床医生提供抗肥胖药物（AOM）作为强化生活方式干预的辅助手段：最近的儿科指南建议临床医生提供抗肥胖药物（AOM），作为强化生活方式干预的辅助手段：调查儿科医生对开具抗肥胖药物处方的看法，包括障碍和促进因素：通过电子邮件向一个学术附属网络内的初级儿科医师（187 人）和高级医疗服务提供者（190 人）发送了一份由研究人员开发的调查问卷。调查评估了临床医生开具 AOM 处方的意愿以及他们对 25 项障碍和促进因素声明的认同程度。三个小故事探讨了 AOM 的决策问题。采用多项式逻辑回归法根据对每项陈述的同意程度确定处方意愿的相对风险比：在 74 名受访者中（回复率为 20%），24% 愿意开处方，42% 不确定，34% 不愿意。大多数受访者（64%）同意 AOM 只应由专科医生管理。愿意开处方与临床医生的积极性以及对指南实用性和适用性的信念有关。不愿意处方则与以下信念有关：患者不会持续服用AOM足够长的时间以获得益处，以及没有足够的时间或资源来实施。在小故事中，52%的人愿意为患有严重肥胖症和代谢并发症的患者开具AOM处方，而为患有肥胖症和可能存在饮食紊乱的患者开具AOM处方的比例仅为11%：开具AOM处方的意愿较低，这与患者认为的实用性和适当性有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Primary care perspectives on prescribing anti-obesity medication for adolescents

查看原文本刊更多论文

Primary care perspectives on prescribing anti-obesity medication for adolescents

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.

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来源期刊

Pediatric Obesity PEDIATRICS-

CiteScore

7.30

自引率

5.30%

发文量

117

审稿时长

6-12 weeks

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.