Re-referring Children for Multidisciplinary Obesity Management

Area of Science:

• Pediatric Endocrinology
• Public Health
• Clinical Pediatrics

Background:

• Childhood obesity is a significant public health concern requiring effective management strategies.
• Understanding referral patterns and their impact on treatment initiation is crucial for optimizing care.
• Multidisciplinary clinics play a key role in managing pediatric obesity.

Purpose of the Study:

• To analyze characteristics of children referred for obesity management based on referral frequency.
• To identify child- and referrer-related variables associated with re-referral.
• To determine if re-referral influences treatment initiation in pediatric obesity management.

Main Methods:

• Population-level, retrospective analysis of 2- to 17-year-olds referred for obesity management (April 2013-December 2017).
• Children categorized as referred once or re-referred.
• Logistic regression and generalized estimating equations used to analyze referral data.

Main Results:

• 10.2% of 2745 children were re-referred, most (92.0%) twice.
• Re-referral was less likely if referred by a family physician or if an appointment was scheduled.
• Treatment initiation was higher in children referred once (42.1%) versus re-referred (18.0%).
• Re-referred children showed increased treatment initiation after the second referral (aOR 2.3), but this was not sustained.

Conclusions:

• Re-referral for pediatric obesity management is infrequent.
• A single re-referral can increase the likelihood of initiating treatment.
• Further research may explore sustained treatment engagement following re-referrals.