Br J Gen Pract. 2005 Oct;55(519):743-9.
Healthcare costs attributable to obesity have previously involved estimations based on costs of diseases commonly considered as having obesity as an underlying factor.
To quantify the impact of obesity on total primary care drug prescribing.
Review of computer generated and handwritten prescriptions to determine total prescribing volume for all drug classes.
Twenty-three general practice surgeries in the UK.
Stratified random selection of 1150 patients who were obese (body mass index [BMI]>30 kg/m(2)) and 1150 age and sex-matched controls of normal weight (BMI 18.5-<25 kg/m(2)). Retrospective review of medical records over an 18-month period.
A higher percentage of patients who were obese, compared with those of normal weight, were prescribed at least one drug in the following disease categories: cardiovascular (36% versus 20%), central nervous system (46% versus 35%), endocrine (26% versus 18%), and musculoskeletal and joint disease (30% versus 22%). All of these categories had a P-value of <0.001. Other categories, such as gastrointestinal (24% versus 18%), infections (42% versus 35%), skin (24% versus 19%) had a P-value of <0.01, while respiratory diseases (18% versus 21%) had a P-value of <0.05. Total prescribing volume was significantly higher for the group with obesity and was increased in the region of two- to fourfold in a wide range of prescribing categories: ulcer healing drugs, lipid regulators, beta-adrenoreceptor drugs, drugs affecting the rennin angiotensin system, calcium channel blockers, antibacterial drugs, sulphonylureas, biguanides, non-steroidal anti-inflammatories (NSAIDs) (P<0.001) and fibrates, angiotensin II antagonists, and thyroid drugs (P<0.05). The main impact on prescribing volumes is from numbers of patients treated, although in some areas there is an effect from greater dosage or longer treatment in those who are obese including calcium channel blockers, antihistamines, hypnotics, drugs used in the treatment of nausea and vertigo, biguanides, and NSAIDs (P<0.05) reflected in significantly increased defined daily dose prescribing.
This large study of contemporary practice indicates that obesity more than doubled prescribing in most drug categories.
以往肥胖导致的医疗费用估算基于通常认为以肥胖为潜在因素的疾病成本。
量化肥胖对初级保健药物总处方量的影响。
审查计算机生成的和手写的处方，以确定所有药物类别的总处方量。
英国的23家全科诊所。
分层随机选取1150名肥胖患者（体重指数[BMI]>30kg/m²）和1150名年龄及性别匹配的正常体重对照者（BMI 18.5 - <25kg/m²）。回顾18个月期间的病历。
与正常体重者相比，肥胖患者在以下疾病类别中至少开具一种药物的比例更高：心血管疾病（36%对20%）、中枢神经系统疾病（46%对35%）、内分泌疾病（26%对18%）以及肌肉骨骼和关节疾病（30%对22%）。所有这些类别P值均<0.001。其他类别，如胃肠道疾病（24%对18%）、感染性疾病（42%对35%）、皮肤疾病（24%对19%）P值<0.01，而呼吸系统疾病（18%对21%）P值<0.05。肥胖组的总处方量显著更高，在广泛的处方类别中增加了两到四倍：溃疡愈合药物、血脂调节剂、β-肾上腺素受体药物、影响肾素血管紧张素系统的药物、钙通道阻滞剂、抗菌药物、磺脲类药物、双胍类药物、非甾体抗炎药（NSAIDs）（P<0.001）以及贝特类药物、血管紧张素II拮抗剂和甲状腺药物（P<0.05）。对处方量的主要影响来自接受治疗的患者数量，尽管在某些领域，肥胖患者的剂量更大或治疗时间更长也有影响，包括钙通道阻滞剂、抗组胺药、催眠药、用于治疗恶心和眩晕的药物、双胍类药物以及NSAIDs（P<0.05），这反映在限定日剂量处方量显著增加上。
这项对当代实践的大型研究表明，肥胖使大多数药物类别的处方量增加了一倍多。
