Opie C A, Haines H M, Ervin K E, Glenister K, Pierce D
Department of Rural Health Graham Street Shepparton Victoria, The University of Melbourne, Victoria, 3630, Australia.
BMC Public Health. 2017 May 23;17(1):500. doi: 10.1186/s12889-017-4434-1.
In Australia people with a diagnosed chronic condition can be managed on unique funded care plans that allow the recruitment of a multidisciplinary team to assist in setting treatment goals and adequate follow up. In contrast to the World Health Organisation, the North American and European Medical Associations, the Australian Medical Association does not recognise obesity as a chronic condition, therefore excluding a diagnosis of obesity from qualifying for a structured and funded treatment plan. BODY: The Australian guidelines for management of Obesity in adults in Primary Care are structured around a five step process -the '5As': Ask & Assess, Advise, Assist and Arrange'. This article aims to identify the key challenges and successes associated with the '5As' approach, to better understand the reasons for the gap between the high Australian prevalence of overweight and obesity and an actual diagnosis and treatment plan for managing obesity. It argues that until the Australian health system follows the international lead and defines obesity as a chronic condition, the capacity for Australian doctors to diagnose and initiate structured treatment plans will remain limited and ineffective.
Australian General Practitioners are limited in their ability manage obesity, as the current treatment guidelines only recognise obesity as a risk factor rather than a chronic condition.
在澳大利亚,被诊断患有慢性病的患者可通过独特的资助护理计划进行管理,该计划允许组建多学科团队协助设定治疗目标并进行充分的随访。与世界卫生组织、北美和欧洲医学协会不同,澳大利亚医学协会不将肥胖视为一种慢性病,因此肥胖诊断不符合结构化资助治疗计划的条件。
澳大利亚初级保健中成人肥胖管理指南围绕“5A”五步流程构建,即询问与评估(Ask & Assess)、建议(Advise)、协助(Assist)和安排(Arrange)。本文旨在确定与“5A”方法相关的关键挑战和成功之处,以更好地理解澳大利亚超重和肥胖高患病率与肥胖实际诊断及治疗计划之间存在差距的原因。文章认为,在澳大利亚卫生系统遵循国际领先做法并将肥胖定义为慢性病之前,澳大利亚医生诊断和启动结构化治疗计划的能力将仍然有限且无效。
澳大利亚全科医生管理肥胖的能力有限,因为当前治疗指南仅将肥胖视为一个风险因素而非慢性病。