O3032: Bridging the Gap: bringing the New AAP Obesity Clinical Practice Guidelines into Real Patient Care - Anti-obesity Medication Initiation

Purpose/Objectives: The 2023 AAP Clinical Practice Guidelines were published in February 2023. Although there is a plethora of evidence based information, many pediatric providers still do not feel comfortable with the translation of these guidelines into the primary care office. In particular, many pediatric providers do not feel comfortable with prescribing anti-obesity medications. In order to simplify the guidelines and to make them more applicable to real life practice, an algorithm and table were designed by a board-certified obesity medicine pediatrician as a reference tool specifically designed for pediatric primary care providers.

Design/Methods: The 2023 AAP Clinical Practice Guidelines were printed and thoroughly reviewed. The section on pharmacotherapy was further evaluated, and a gap was identified in regards to decision making when prescribing FDA approved anti-obesity medications for adolescents age 12 yrs and older. This clinical flow diagram is meant to be complementary to behavior and lifestyle counseling within the pediatric medical home. After a rough paper sketch of typical decision making that should occur, a clinical flow chart was created using Canva free templates. In addition, the patient drug inserts of all three FDA approved anti-obesity medications were reviewed and summarized in table format.

Results: An clinical flow chart entitled "Initiation of Anti-Obesity Medications (AOMs) for Adolescents with Obesity" was created to help to empower primary care providers to gain confidence in prescribing the three currently FDA approved anti-obesity medications for adolescents age 12 yrs and older. A table was also created to summarize the medication dosing, mechanism of action, mean weight loss, contraindications, precautions/notes, clinical indications, and side effects of these medications.

Conclusion/Discussion: Although the 2023 AAP Clinical Practice Guidelines offer a robust amount of evidence-based guidance, the opportunity to simplify the material into practical flowsheets, tables, and algorithms that a primary care provider can reference in their busy clinical practice remains. Pediatric and Adolescent Obesity is a chronic disease that is best handled in the pediatric medical home, but more practical tools are needed to support pediatricians. Pediatricians can and should feel comfortable with the initiation of the three FDA approved anti-obesity medications that are currently available for adolescents age 12 yrs and older (always in conjunction with behavior and lifestyle counseling). The burden of obesity is too large to depend on pediatric subspecialists, and simple tools can help to bridge the gap by empowering pediatric providers to provide evidence based obesity care within the medical home.