Demand for health services and drug prescriptions among overweight or obese preschool children

Ortiz-Pinto, Maira Alejandra; Ortiz-Marrón, Honorato; Esteban-Vasallo, María D.; Quadrado-Mercadal, Agueda; Casanova-Pardomo, Dayami; González-Alcón, Marta; Ordobás‐Gavín, María; Galán, Iñaki

doi:10.1136/archdischild-2019-316895

Cited by 4 publications

(17 citation statements)

References 30 publications

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“…One study analysed data collected as part of an established cohort study, 24 while the others made use of routinely collected health records. A total of 1 232 895 children were included in the four studies, with sample sizes ranging from 1844 children 24 to almost 600 000, 23 and follow-up from 2 24 to 13 years. 23 Of the studies reporting their study sample sex distribution, 51.4% of the sample were male.…”

Section: Resultsmentioning

confidence: 99%

Are children with obesity at school entry more likely to have a diagnosis of a musculoskeletal condition? Findings from a systematic review

Firman

Wilk

Harper

et al. 2022

bmjpo

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BackgroundChildren with obesity at school entry are at increased risk of persistent obesity throughout childhood and adulthood. Little is known about associations with adverse health outcomes with onset during childhood including those affecting the musculoskeletal system. We examined the association between obesity present at school entry and adverse musculoskeletal diagnoses with onset during childhood.MethodsWe searched three electronic databases to identify longitudinal studies published in English between January 2000 and June 2022 assessing associations between obesity measured at school entry (around age 5 years) and musculoskeletal diagnoses made before age 20 years. Two reviewers screened titles, abstracts and full-text using EPPI-Reviewer software. Bias and quality of eligible studies were appraised using The Quality Assessment tool for Observational Cohort and Cross-sectional studies and findings synthesised.ResultsWe identified four eligible studies from 291 unique records, three conducted in Spain and one in Scotland. These studies reported on 1 232 895 children (available data: 51.4% boys; none reported ethnic distribution) with study sample sizes ranging from <2000 to 600 000 and length of follow-up from 2 to 13 years. Quantitative synthesis of findings across these four studies was not possible due to differences in outcomes and effect sizes reported. Children with obesity at school entry were more likely to receive diagnoses of slipped capital femoral epiphysis, back pain, fractures and musculoskeletal complaints made in primary care settings. Included studies were assessed as of ‘fair’ to ‘good’ quality.ConclusionThere is good to fair evidence to suggest children with obesity at school entry are more likely to receive a diagnosis of a musculoskeletal condition during childhood. Further research is needed to replicate these findings in ethnically diverse populations and to investigate whether these are causal associations. The implications of this for children’s mobility and quality of life and future musculoskeletal health warrants further assessment.

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Section: Resultsmentioning

confidence: 99%

Are children with obesity at school entry more likely to have a diagnosis of a musculoskeletal condition? Findings from a systematic review

Firman

Wilk

Harper

et al. 2022

bmjpo

View full text Add to dashboard Cite

show abstract

“…The most commonly reported outcome measures were emergency department (ED) visits (n=10) 32–34 37–43 and outpatient (n=11) visits (including primary care and specialty visits). 32–34 36–41 43 44 Seven studies reported on healthcare use associated with respiratory diseases, 41 44–49 two reported on musculoskeletal conditions 44 50 and two on conditions concerning mental health. 37 44 The rest of the studies analysed the overall healthcare use in children with no reporting on reasons for utilisation.…”

Section: Resultsmentioning

confidence: 99%

“…Two studies reported a non-significant decrease in admissions. 44 56 In addition, one study reported that 14.5% of obese or overweight children were admitted, compared with 16.5% normal-weight children. 42 For overweight children, one study reported a significant decrease 56 while one reported a non-significant decrease 37 in admissions compared with normal-weight children.…”

Section: Resultsmentioning

confidence: 99%

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Healthcare utilisation in overweight and obese children: a systematic review and meta-analysis

et al. 2020

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ObjectiveThis systematic review and meta-analysis aims to systematically analyse the association of overweight and obesity with health service utilisation during childhood.Data sourcesPubMed, MEDLINE, CINAHL, EMBASE and Web of Science.MethodsObservational studies published up to May 2020 that assessed the impact of overweight and obesity on healthcare utilisation in children and adolescents were included. Studies were eligible for inclusion if the included participants were ≤19 years of age. Findings from all included studies were summarised narratively. In addition, rate ratios (RRs) and 95% CIs were calculated in a meta-analysis on a subgroup of eligible studies.Outcome measuresIncluded studies reported association of weight status with healthcare utilisation measures of outpatient visits, emergency department (ED) visits, general practitioner visits, hospital admissions and hospital length of stay.ResultsThirty-three studies were included in the review. When synthesising the findings from all studies narratively, obesity and overweight were found to be positively associated with increased healthcare utilisation in children for all the outcome measures. Six studies reported sufficient data to meta-analyse association of weight with outpatient visits. Five studies were included in a separate meta-analysis for the outcome measure of ED visits. In comparison with normal-weight children, rates of ED (RR 1.34, 95% CI 1.07 to 1.68) and outpatient visits (RR 1.11, 95% CI 1.02 to 1.20) were significantly higher in obese children. The rates of ED and outpatient visits by overweight children were only slightly higher and non-significant compared with normal-weight children.ConclusionsObesity in children is associated with increased healthcare utilisation. Future research should assess the impact of ethnicity and obesity-associated health conditions on increased healthcare utilisation in children with overweight and obesity.PROSPERO registration numberCRD42018091752

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Are children living with obesity more likely to experience musculoskeletal symptoms during childhood? A linked longitudinal cohort study using primary care records

Firman,

Homer,

Harper

et al. 2024

Arch Dis Child

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ObjectiveTo assess whether there is a higher incidence of musculoskeletal consultations in general practice among children with obesity.DesignLongitudinalSetting285 north-east London general practitioners (GPs).Participants63 418 (50.9% boys) Reception and 55 364 (50.8% boys) Year 6 National Child Measurement Programme (NCMP) participants, linked to GP electronic health records (EHRs).Main outcome measureA GP consultation with a recorded musculoskeletal symptom or diagnosis.MethodsWe calculated proportions with a musculoskeletal consultation by ethnic-adjusted weight status (underweight <2nd; overweight ≥91st; obese ≥98th centile), sex, ethnicity, and area-level deprivation. We estimated mutually-adjusted hazard ratios (HR) and 95% confidence intervals (95% CI) using Cox’s proportional regression models stratified by school year and sex.ResultsWe identified 1868 (3.0%) Reception and 4477 (8.1%) Year 6 NCMP participants with at least one musculoskeletal consultation. In adjusted analyses, Reception year girls with a body mass index (BMI) classified as overweight (HR 1.24, 95% CI 1.02 to 1.52) or obese (HR 1.67, 95% CI 1.35 to 2.06) were more likely to have at least one musculoskeletal consultation. Year 6 girls with obesity were more likely (HR 1.20, 95% CI 1.07 to 1.35), and boys with a BMI in the underweight range were less likely (HR 0.39, 95% CI 0.21 to 0.73), to have a musculoskeletal consultation.ConclusionsGirls living with obesity at the start or end of primary school are more likely to attend their GP for a musculoskeletal consultation. Routine linkage of NCMP data to EHRs provides useful insights into childhood health conditions related to excess weight in early childhood. Recognition of obesity as a contributing factor for musculoskeletal symptoms may inform clinical management, particularly in girls.

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Demand for health services and drug prescriptions among overweight or obese preschool children

Cited by 4 publications

References 30 publications

Are children with obesity at school entry more likely to have a diagnosis of a musculoskeletal condition? Findings from a systematic review

Are children with obesity at school entry more likely to have a diagnosis of a musculoskeletal condition? Findings from a systematic review

Healthcare utilisation in overweight and obese children: a systematic review and meta-analysis

Are children living with obesity more likely to experience musculoskeletal symptoms during childhood? A linked longitudinal cohort study using primary care records

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