Clinician identification of youth abusing over-the-counter products for weight control in a large U.S. integrated health systemReport as inadecuate




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Journal of Eating Disorders

, 1:40

First Online: 21 October 2013Received: 06 August 2013Accepted: 19 September 2013DOI: 10.1186-2050-2974-1-40

Cite this article as: Austin, S.B., Penfold, R.B., Johnson, R.L. et al. J Eat Disord 2013 1: 40. doi:10.1186-2050-2974-1-40

Abstract

BackgroundAbuse of over-the-counter OTC products, such as diet pills and laxatives, for weight control by adolescents is well-documented and can precipitate serious medical conditions. Yet only a small percentage of youth with disordered weight control behaviors receive treatment. The objective of this study was to examine how often clinicians communicate with youth with symptoms consistent with abuse of OTC products for weight control about possible use of these products.

We used electronic medical records and administrative claims for services for 53,229 12 to 17 year old patients receiving care from an integrated health system in the U.S. Northwest from August 2007 to December 2010. We examined electronic text of clinical notes to identify encounters in which the clinician noted one of 10 metabolic conditions potentially associated with abuse of OTC products diet pills, laxatives, diuretics, ipecac, orlistat, and alli® for weight control and then assessed whether clinicians noted communication with adolescent patients about possible use of OTC products for weight control.

ResultsWe identified 130 0.2% of sample patients with clinical notes indicating one or more of the metabolic conditions. In clinical notes for only four 3.1% of these patients did clinicians document suspicion or communication about possible abuse of the OTC products. All four had a previous eating disorder diagnosis. In the 12 months subsequent to the clinical encounter in which a metabolic disturbance was identified, medical notes for only three 2.3% of the 130 patients indicated clinician suspicion or communication about possible abuse of these products or an eating disorder.

ConclusionsClinicians are missing a critical window of opportunity to query adolescents when presenting with suspicious metabolic disturbances about possible abuse of OTC products for weight control. Clinicians may need more training to detect OTC product abuse, and electronic medical records should prompt more thorough enquiry.

KeywordsAdolescence Diet pills Diuretics Laxatives Eating disorder Electronic medical record  Download fulltext PDF



Author: S Bryn Austin - Robert B Penfold - Ron L Johnson - Jess Haines - Sara Forman

Source: https://link.springer.com/







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