2002-2005 Trends in the Prevalence of Obesity-Related Chronic Medication Use in Children

Objective: To estimate prevalence and evaluate trends in obesity-related chronic medication use among children. Design, Setting, and Participants: Cross sectional study of ambulatory prescription claims from 2002 to 2005 for a sample of over 3.5 million commercially-insured children 5 to 19 years. Main Outcome Measures: Quarterly prevalence and trends in the prevalence of use for antihypertensives, type 2 antidiabetics, antidepressants, and statins. Results: In 2002, the prevalence per 1,000 child beneficiaries of antihypertensive prescription use overall was 2.35 (1.12 for beta blockers, 0.65 for ACE/ARB, 0.49 for diuretics, and 0.33 for calcium channel blockers). The prevalence of type 2 antidiabetic prescription use was 0.31, for statins was 0.22, and for antidepressants was 15.65 per 1,000 child beneficiaries. 2002-2005 use of antihypertensives increased by 2% overall (6% among children 15 to 19 years); ACE/ARB and diuretics grew by 20% and 10%, respectively, while use of beta blockers and calcium channel blockers declined (-8% and -16%, respectively). The prevalence rate for type 2 anti-diabetic agents doubled driven by a 166% and 135% increase among females age 10 to 14 and 15 to 19 years, respectively. Statin use declined by 5.5% while use of antidepressants remained relatively flat, growing at a rate of only 2%. Conclusions: The trends in obesity-related drug therapy are not consistent with recent trends in childhood obesity. The negligible increase in antihypertensives, decreased statin prevalence and a doubling of type 2 anti-diabetics over four years suggest a different criteria for screening and treatment for these chronic conditions in children.