Anti-obesity medication prescriptions by race/ethnicity and use of an interpreter in a pediatric weight management clinic

Eric M. Bomberg, Elise F. Palzer, Kyle D. Rudser, Aaron S. Kelly, Carolyn T. Bramante, Hilary K. Seligman, Favour Noni, Claudia K. Fox

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5 Scopus citations

Abstract

Background: Race/ethnicity and low English proficiency healthcare disparities are well established in the United States. We sought to determine if there are race/ethnicity differences in anti-obesity medication (AOM) prescription rates among youth with severe obesity treated in a pediatric weight management clinic and if, among youth from non-primary English speaking families, there are differences in prescriptions between those using interpreters during visits versus not. Methods: We reviewed electronic health records of 2- to 18-year-olds with severe obesity seen from 2012 to 2021. Race/ethnicity was self-report, and AOMs included topiramate, stimulants (e.g. phentermine, lisdexamfetamine), naltrexone (±bupropion), glucagon-like peptide-1 agonists, and orlistat. We used general linear regression models with log-link to compare incidence rate ratios (IRRs) within the first 1 and 3 years of being followed, controlling for age, percent of the 95th BMI percentile (%BMIp95), number of obesity-related comorbidities (e.g. insulin resistance, hypertension), median household income, and interpreter use. We repeated similar analyses among youth from non-primary English speaking families, comparing those using interpreters versus not. Results: 1,725 youth (mean age 11.5 years; %BMIp95 142%; 53% non-Hispanic White, 20% Hispanic/Latino, 16% non-Hispanic black; 6% used interpreters) were seen, of which 15% were prescribed AOMs within 1 year. The IRR for prescriptions was lower among Hispanic/Latino compared to non-Hispanic White youth at one (IRR 0.70; CI: 0.49–1.00; p = 0.047) but not 3 years. No other statistically significant differences by race/ethnicity were found. Among non-primary English speaking families, the IRR for prescriptions was higher at 1 year (IRR 2.49; CI: 1.32–4.70; p = 0.005) in those using interpreters versus not. Conclusions: Among youth seen in a pediatric weight management clinic, AOM prescription incidence rates were lower in Hispanics/Latinos compared to non-Hispanic Whites. Interpreter use was associated with higher prescription incidence rates among non-primary English speakers. Interventions to achieve equity in AOM prescriptions may help mitigate disparities in pediatric obesity.

Original languageEnglish (US)
JournalTherapeutic Advances in Endocrinology and Metabolism
Volume13
DOIs
StatePublished - Apr 2022

Bibliographical note

Funding Information:
The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: E.M.B. is a site principal investigator and co-investigator for Novo Nordisk. A.S.K. serves as an unpaid consultant for Novo Nordisk, Vivus, and Eli Lilly, and receives donated drug and placebo from Vivus for a National Institutes of Diabetes and Digestive and Kidney Diseases (NIDDK)-funded clinical trial. C.T.B. is funded by the NIH National Center for Advancing Translational Sciences, grants KL2TR002494 and UL1TR002494. C.K.F. is a site principal investigator and co-investigator for Novo Nordisk. All other authors have no other relevant disclosures. Research reported in this publication was supported by the NIDDK of the National Institutes of Health under Award Number K23DK125668. Additional support was provided by the Minnesota Population Center, which is funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (Grant P2 C HD041023), and award number UL1TR002494 from the National Institutes of Health’s National Center for Advancing Translational Sciences. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Publisher Copyright:
© The Author(s), 2022.

Keywords

  • anti-obesity agents
  • healthcare disparities
  • limited english proficiency
  • obesity
  • pediatric obesity

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