Medication use in normal weight and overweight children in a nationally representative sample of Canadian children

School of Public Health, University of Alberta, 350 University Terrace, Edmonton, Alberta, Canada.
Archives of Disease in Childhood (Impact Factor: 2.9). 07/2012; 97(9):842-7. DOI: 10.1136/archdischild-2011-301195
Source: PubMed


As overweight and obese children are more likely to develop serious medical conditions, they incur higher doctor and hospital costs compared to their normal weight counterparts. Consequently, the differential healthcare costs between obese and normal weight children may be even greater if medication use is considered.
To compare medication use between normal weight and overweight children in a nationally representative sample from Canada.
Data from the Canadian Health Measures Survey 2007/2009, a cross-sectional survey assessing indicators of health and wellness in Canadians, was used in the current study. The analysis included 2087 children and adolescents between 6-19 years of age with valid measures of body mass index (BMI). Poisson/negative binomial regression was used to examine the association between weight status and the number of medications taken in the last month.
For 6-11 year olds, the frequency of prescription, over-the-counter and natural health product (NHP) medication use did not differ between normal weight and overweight/obese children. For 12-19 year olds, overweight/obese children used prescription medication significantly more often than their normal weight peers (adjusted incidence rate ratio (IRR), 1.59; 95% CI 1.19 to 2.14), whereas for NHP the opposite was the case (adjusted IRR, 0.52; 95% CI 0.32 to 0.82). These children also used nervous system and respiratory medications more frequently than their normal weight peers.
The findings of the present study suggest that the differential usage of prescription drugs among overweight/obese children underline the need to develop effective obesity prevention programmes and policies that may reduce the health and economic burden of childhood obesity.

1 Follower
1 Read
  • [Show abstract] [Hide abstract]
    ABSTRACT: Obesity affects nearly one-sixth of US children and results in alterations to body composition and physiology that can affect drug disposition, possibly leading to therapeutic failure or toxic side effects. The depth of available literature regarding obesity's effect on drug safety, pharmacokinetics, and dosing in obese children is unknown. To perform a systematic literature review describing the current evidence of the effect of obesity on drug disposition in children. We searched the MEDLINE, Cochrane, and EMBASE databases (January 1, 1970-December 31, 2012) and included studies if they contained data on drug clearance, volume of distribution, or drug concentration in obese children (aged ≤18 years). We compared exposure and weight-normalized volume of distribution and clearance between obese and nonobese children. We explored the association between drug physicochemical properties and clearance and volume of distribution. Twenty studies met the inclusion criteria and contained pharmacokinetic data for 21 drugs. The median number of obese children studied per drug was 10 (range, 1-112) and ages ranged from newborn to 29 years (1 study described pharmacokinetics in children and adults together). Dosing schema varied and were either a fixed dose (6 [29%]) or based on body weight (10 [48%]) and body surface area (4 [19%]). Clinically significant pharmacokinetic alterations were observed in obese children for 65% (11 of 17) of the studied drugs. Pharmacokinetic alterations resulted in substantial differences in exposure between obese and nonobese children for 38% (5 of 13) of the drugs. We found no association between drug lipophilicity or Biopharmaceutical Drug Disposition Classification System class and changes in volume of distribution or clearance due to obesity. Consensus is lacking on the most appropriate weight-based dosing strategy for obese children. Prospective pharmacokinetic trials in obese children are needed to ensure therapeutic efficacy and enhance drug safety.
    05/2015; 169(7). DOI:10.1001/jamapediatrics.2015.132
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Increasing rates of childhood obesity have been suggested as a possible cause for the increasing prevalence of chronic conditions among adults and children. Few studies have examined whether obese children are more likely to use medications than normal weight children. We investigate this association in the UK. A panel study with repeated observations at ages 5, 7 and 11. A general population sample drawn from the Millennium Cohort Study, a UK-based birth cohort. A sample of 9667 children. Our primary outcomes were crude and adjusted probabilities of taking any regular medications and the number of medications among overweight and obese children compared with normal weight children. Our secondary outcome was the distribution of medication use by therapeutic classification across body mass index (BMI) groups. Obese children were more likely to use any medication (marginal effect (ME)=0.02, 95% CI 0.01 to 0.03) and to use more medications (ME=0.08, 95% CI 0.04 to 0.12) than normal weight children. Obese children used more medications for respiratory conditions than those of other BMI groups. Obese children are more likely to use regular medications and have comorbid conditions, even at young ages. This suggests that the cost of prescriptions should be considered when evaluating the economic burden of childhood obesity and that preventative strategies to reduce childhood obesity could be cost-effective in the short as well as in the long term. While more research is needed, both clinicians and policymakers should be aware of these findings when planning prevention and treatment strategies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to
    BMJ Open 06/2015; 5(6). DOI:10.1136/bmjopen-2014-007373 · 2.27 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Child health varies with body mass index (BMI), but it is unknown by what age or how much this attracts additional population health-care costs. We aimed to determine the (1) cross-sectional relationships between BMI and costs across the first decade of life and (2) in longitudinal analyses, whether costs increase with duration of underweight or obesity. Participants: Baby (n = 4230) and Kindergarten (n = 4543) cohorts in the nationally representative Longitudinal Study of Australian Children. Medicare Benefits Scheme (including all general practitioner plus a large proportion of paediatrician visits) plus prescription medication costs to federal government from birth to sixth (Baby cohort) and fourth to tenth (Kindergarten cohort) birthdays. biennial BMI measurements over the same period. Among Australian children under 10 years of age, 5-6% were underweight, 11-18% overweight and 5-6% obese. Excess costs with low and high BMI became evident from age 4-5 years, with normal weight accruing the least, obesity the most, and underweight and overweight intermediate costs. Relative to overall between-child variation, these excess costs per child were very modest, with a maximum of $94 per year at age 4-5 years. Nonetheless, this projects to a substantial cost to government of approximately $13 million per annum for all Australian children aged less than 10 years. Substantial excess population costs provide further economic justification for promoting healthy body weight. However, obese children's low individual excess health-care costs mean that effective treatments are likely to increase short-term costs to the public health purse during childhood. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).
    Journal of Paediatrics and Child Health 06/2015; DOI:10.1111/jpc.12932 · 1.15 Impact Factor