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Giving “prescriptions” for paediatric weight management follow‐up in primary care
Author(s) -
Kharofa Roohi Y.,
Khalsa Amrik Singh,
Zeller Meg H.,
Modi Avani C.,
Ollberding Nicholas J.,
Copeland Kristen A.
Publication year - 2021
Publication title -
clinical obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.64
H-Index - 12
eISSN - 1758-8111
pISSN - 1758-8103
DOI - 10.1111/cob.12448
Subject(s) - medicine , overweight , medicaid , body mass index , medical prescription , odds , weight management , logistic regression , obesity , odds ratio , primary care , pediatrics , attendance , population , primary care physician , family medicine , health care , nursing , environmental health , economics , economic growth
Summary The American Academy of Paediatrics recommends that primary care paediatricians “prescribe” follow‐up for weight management between well child checks. We sought to describe rates and predictors of prescribed and actual clinic attendance for weight management in primary care in a predominantly low‐income population. A chart review was performed at a large, hospital‐based, primary care clinic, where a treatment algorithm for obesity exists. Eligible children were 6 to 12 years of age with a body mass index (BMI) ≥85th percentile and seen for a well child check in 2014. Primary outcomes were the physician prescribing follow‐up in primary care and the patient returning for weight management. Multivariable logistic regression was used to identify predictors of prescribing follow‐up and predictors of return. Participants included 1339 patients: mean age 9 years (SD: 1.8 years); 53% female; 79% Black; 89% Medicaid‐insured; 56% with an obese BMI (vs overweight). Twenty‐seven percent of patients were prescribed follow‐up in primary care, of which 13% returned (only 4% of the original sample). The odds of the physician prescribing follow‐up were greater if the child had obesity (vs overweight), was older, female or non‐Medicaid insured. Older and non‐Black patients had greater odds of returning. Patients prescribed follow‐up within 2 months or less (vs 3‐6 months) were also more likely to return (aOR 2.66; CI: 1.34, 5.26). Rates of prescription for weight management in primary care are low and few patients return, even when follow‐up is prescribed. Prescribing follow‐up at shorter intervals from the index visit (≤ 2 months) may improve patient return.