Evidence map›Paper›PMID 36564960›Full record

ArticlePharmacotherapy2023

Polypharmacy among medicaid-insured children with and without documented obesity.

Kathryn E Kyler, Matt Hall, James W Antoon, Jennifer Goldman, Carlos G Grijalva, Samir S Shah, Sonya Tang Girdwood, Derek J Williams, James A Feinstein

Open access · greenAbstract read
In one paragraph

Article in Pharmacotherapy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.5field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 1 country.

Kathryn E KylerDivision of Hospital Medicine, Children's Mercy Kansas City, Kansas City, Missouri, USA.ORCID 0000-0002-5631-2228
Matt HallDivision of Hospital Medicine, Children's Mercy Kansas City, Kansas City, Missouri, USA.
James W AntoonDivision of Hospital Medicine, Department of Pediatrics, Vanderbilt University School of Medicine and the Monroe Carell Jr. Children's Hospital at Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID 0000-0001-6188-2658
Jennifer GoldmanDivision of Clinical Pharmacology, Children's Mercy Hospitals and Clinics, Kansas City, Missouri, USA.
Carlos G GrijalvaDivision of Pharmacoepidemiology, Departments of Health Policy and Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Samir S ShahDivisions of Hospital Medicine and Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Sonya Tang GirdwoodDepartment of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.ORCID 0000-0001-7737-8499
Derek J WilliamsDivision of Hospital Medicine, Department of Pediatrics, Vanderbilt University School of Medicine and the Monroe Carell Jr. Children's Hospital at Vanderbilt University Medical Center, Nashville, Tennessee, USA.
James A FeinsteinAdult and Child Consortium for Health Outcomes Research & Delivery Science, Children's Hospital Colorado, University of Colorado, Aurora, Colorado, USA.ORCID 0000-0003-3074-8805
Children's Mercy Hospital · USCincinnati Children's Hospital Medical Center · USMonroe Carell Jr. Children's Hospital · USOutcomes Research Consortium · USVanderbilt University Medical Center · US

Funding

Pediatric Center--Gene Expression /Developmental ScienceK12HD028827 · NICHD · CINCINNATI CHILDRENS HOSP MED CTR · PI Tina Lee Cheng · 2002 to 2026
$9.6M
Risk Stratification and Decision Support to Improve Care and Outcomes in Children with PneumoniaR01AI125642 · NIAID · VANDERBILT UNIVERSITY MEDICAL CENTER · PI WILLIAMS, DEREK J. · 2017 to 2021
$3.3M
Vanderbilt Scholars in T4 Translational Research (V-STTaR) ProgramK12HL137943 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI KRIPALANI, SUNIL, ROUMIE, CHRISTIANNE L. · 2017 to 2021
$2.9M
Mentoring in transmission of influenza and strategies for preventionK24AI148459 · NIAID · VANDERBILT UNIVERSITY MEDICAL CENTER · PI GRIJALVA, CARLOS G · 2020 to 2024
$893k
Enhancing Medication Safety in Children with Polypharmacy Using Parent-Reported Symptom AssessmentsK23HD091295 · NICHD · UNIVERSITY OF COLORADO DENVER · PI FEINSTEIN, JAMES A · 2017 to 2021
$826k
Oseltamivir Use and Risk of Serious Neuropsychiatric Adverse Events in ChildrenK23AI168496 · NIAID · VANDERBILT UNIVERSITY MEDICAL CENTER · PI ANTOON, JAMES W · 2022 to 2025
$740k
NHLBI NIH HHS K12 HL137943NIAID NIH HHS K23 AI168496NIAID NIH HHS K24 AI148459NIAID NIH HHS R01 AI125642NICHD NIH HHS K12 HD028827NICHD NIH HHS K23 HD091295
6 · The paper itself

Abstract

objectivePolypharmacy increases the risk of drug-drug interactions and adverse drug events. As obesity and rates of obesity-associated comorbid chronic conditions continue to rise, an improved understanding of whether children with obesity experience higher risk of polypharmacy is needed. This study aimed to compare chronic medication polypharmacy prevalence among children with and without a diagnosis of obesity.

methodsWe performed a cross-sectional examination of prescription data for children aged 2-18 years prescribed ≥1 chronic medication using the 2019 Marketscan Medicaid database. Children with documented obesity were identified using medical visit diagnosis codes. Chronic medications included any ≥30-day prescription with ≥2 dispensed refills. Polypharmacy was defined as the prescription of ≥2 chronic medications for ≥1 overlapping days. Chi-squared tests compared polypharmacy prevalence and the distribution of chronic medication classes between children with and without obesity. Logistic regression determined the adjusted odds ratio (aOR) of polypharmacy for children with obesity, adjusting for relevant demographic and clinical differences.

resultsOf 634,671 included children, 12.2% had documented obesity. More than one-half (52.7%) of children with obesity experienced polypharmacy compared with 47.6% of children without obesity (aOR 1.06 [95% confidence interval 1.04-1.08]). Chronic medication prescriptions, particularly for psychiatric and asthma medications, were more commonly prescribed among children with obesity than those without obesity.

conclusionsChildren with documented obesity have higher polypharmacy prevalence than children without obesity. Clinicians must be aware of this risk and minimize inappropriate polypharmacy whenever possible. Future work should examine the consequences of polypharmacy, including drug-drug interactions and adverse drug events in children with obesity.

Indexed as

Drug-Related Side Effects and Adverse ReactionsMedicaidChildCross-Sectional StudiesHumansObesityPolypharmacyRetrospective StudiesUnited Stateschronic conditionsdrug interactionsobesitypolypharmacy

Identifiers

PMID36564960
PMCPMC10287842
OpenAlexW4312118133

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.