Welbourn Richard, Dixon John, Barth Julian H, Finer Nicholas, Hughes Carly A, le Roux Carel W, Wass John
Department of Upper GI and Bariatric Surgery, Musgrove Park Hospital, Taunton, TA1 5DA, UK.
Baker IDI Heart and Diabetes Institute, Melbourne, Australia.
Obes Surg. 2016 Mar;26(3):649-59. doi: 10.1007/s11695-015-2041-8.
Despite increasing prevalence of obesity, no country has successfully implemented comprehensive pathways to provide advice to all the severely obese patients that seek treatment. We aimed to formulate pathways for referral into and out of weight assessment and management clinics (WAMCs) that include internal medicine/primary care physicians as part of a multidisciplinary team that could provide specialist advice and interventions, including referral for bariatric surgery. Using a National Institute of Health and Care Excellence (NICE)-accredited process, a Guidance Development Group conducted a literature search identifying existing WAMCs. As very few examples of effective structures and clinical pathways existed, the current evidence base for optimal assessment and management of bariatric surgery patients was used to reach a consensus. The model we describe could be adopted internationally by health services to manage severely obese patients.
尽管肥胖症的患病率不断上升，但没有一个国家成功实施全面的途径，为所有寻求治疗的严重肥胖患者提供建议。我们旨在制定体重评估和管理诊所（WAMCs）的转诊途径，将内科/初级保健医生纳入多学科团队，该团队可以提供专业建议和干预措施，包括转诊进行减肥手术。一个指南制定小组采用英国国家卫生与临床优化研究所（NICE）认可的流程进行了文献检索，以确定现有的WAMCs。由于有效的结构和临床途径的例子很少，因此利用目前关于肥胖症手术患者最佳评估和管理的证据基础来达成共识。我们所描述的模式可供卫生服务机构在国际上采用，以管理严重肥胖患者。
