Potential barriers to the use of anti‐obesity medications in persons with spinal cord injuries and disorders

Author:

LaVela Sherri L.12ORCID,Berryman Kelsey1ORCID,Kale Ibuola1ORCID,Farkas Gary J.34ORCID,Henderson Geoffrey V.5ORCID,Rosales Vanessa1ORCID,Eisenberg Dan67ORCID,Reyes Lorena18ORCID

Affiliation:

1. Department of Veterans Affairs Center of Innovation for Complex Chronic Healthcare (CINCCH) Edward Hines Jr. VA Hospital Hines Illinois USA

2. Department of Physical Medicine and Rehabilitation Feinberg School of Medicine Northwestern University Chicago Illinois USA

3. Department of Physical Medicine and Rehabilitation University of Miami Miller School of Medicine Miami Florida USA

4. Miami Project to Cure Paralysis University of Miami Miller School of Medicine Miami Florida USA

5. Department of Physical Medicine and Rehabilitation SUNY Upstate Medical University Syracuse New York USA

6. Center for Innovation to Implementation VA Palo Alto Health Care System Palo Alto California USA

7. Stanford‐Surgery Policy Improvement Research & Education Center Stanford University School of Medicine Stanford California USA

8. Nutrition and Food Services VA Edward Hines, Jr. Hines Illinois USA

Abstract

AbstractBackgroundAnti‐obesity medications (AOMs) may provide a viable option for obesity management. However, little is known about the use of AOMs in persons with SCI/D.ObjectiveDescribe health care providers' (HCPs) views about barriers to AOM use in persons living with SCI/D.MethodsDescriptive qualitative design using in‐depth interviews Descriptive statistics were used to calculate demographic and employment characteristics. Interviews were audio‐recorded and transcribed verbatim. Transcripts were coded and analyzed using Braun and Clarke's (2006) six thematic analysis phases.ResultsHCPs (n = 12) were from 11 different nationwide facilities. Most HCPs were male (75%), a large majority were white (67%), and most were 26–49 years of age. Participants were dietitians (75%), physicians (17%), and psychologists (8%). HCPs ranged from 1.5 to 15 years of providing SCI/D care. HCPs described four main thematic barriers to AOM use in persons with SCI/D: (1) AOM side effects that are especially concerning in persons with SCI/D; (2) AOMs contribute to poor eating habits; (3) availability, accessibility, and administration; and (4) lack of evidence, clinical agreement, and knowledge about AOM use in the SCI/D population.ConclusionsThere are several potential barriers to AOM use in the SCI/D population. Barriers include AOM side effects which may cause or exacerbate conditions that are already concerns in persons with SCI/D, such as bowel and skin problems, and muscle loss. SCI/D HCPs reported a lack of evidence about AOM use in persons with SCI/D, but interest in obtaining more knowledge.

Funder

U.S. Department of Veterans Affairs

Health Services Research and Development

Publisher

Wiley

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