Abstract P195: Association Of Unmet Social Needs With Antihypertensive Medication Prescription And Dietitian Referral: Interim Analysis Of The Study Of The Epidemiology Of Pediatric Hypertension Registry (SUPERHERO)

Abstract

HTN is a significant public health concern with increasing prevalence in youth. Optimizing BP control with both lifestyle counseling and antihypertensive medications improves health outcomes. However, adequate BP control remains difficult in majority of patients, in part due to a lack of understanding of how social determinants of health affect dietitian referral and initiation of antihypertensive therapy. We performed a cross-sectional analysis of baseline EHR data from the SUPERHERO Registry in youth who received initial care from sub-specialists for HTN disorders defined by ICD-10 codes from 1/1/2015-12/31/2022. We excluded those with pregnancy, kidney transplantation, and dialysis. We examined the association of individual-level social drivers (transportation, finances, food access housing) with the likelihood of antihypertensive medication prescription and dietitian referral at initial visit in youth with HTN disorders using unadjusted generalized linear models. Of our large cohort of 11,580, only 47 youth had at least one unmet social need (0.4%). Participants with at least one unmet social need were 1.81 times more likely to be prescribed antihypertensive medication (95% CL 0.94- 3.48; p= 0.08) and 6.73 times more likely to be referred to a dietitian (95% CL 3.7-12.25). We found that children with at least one unmet social need were more likely to be referred to a dietitian at the initial visit than those without an unmet social need. The small number of participants with unmet social needs might reflect poor screening or documentation practices. It is imperative that screening for unmet social needs is incorporated into clinical practice in youth with HTN disorders.