Department of Upper GI and Bariatric Surgery, Musgrove Park Hospital, Taunton, UK.
North Bristol Centre for Weight Loss, Metabolic and Bariatric Surgery, Southmead Hospital, Bristol, UK.
Obes Rev. 2018 Jan;19(1):14-27. doi: 10.1111/obr.12601. Epub 2017 Oct 10.
The challenge of managing the epidemic of patients with severe and complex obesity disease in secondary care is largely unmet. In England, the National Institute of Health and Care Excellence and the National Health Service England have published guidance on the provision of specialist (non-surgical) weight management services. We have undertaken a systematic review of 'what evidence exists for what should happen in/commissioning of: primary or secondary care weight assessment and management clinics in patients needing specialist care for severe and complex obesity?' using an accredited methodology to produce a model for organization of multidisciplinary team clinics that could be developed in every healthcare system, as an update to a previous review. Additions to the previous guidance were multidisciplinary team pathways for children/adolescent patients and their transition to adult care, anaesthetic assessment and recommendations for ongoing shared care with general practitioners, as a chronic disease management pathway.
在二级医疗机构中管理严重和复杂肥胖症患者的流行面临着巨大的挑战，这一问题尚未得到解决。在英国，国家卫生与保健卓越研究所和英格兰国家医疗服务体系发布了关于提供专科（非手术）体重管理服务的指南。我们使用认可的方法系统地回顾了“在/委托以下方面存在哪些证据：需要专科治疗严重和复杂肥胖症的患者的初级或二级保健体重评估和管理诊所？”，以制定一种多学科团队诊所的组织模式，该模式可以在每个医疗保健系统中进行开发，作为对以前审查的更新。以前的指南增加了多学科团队途径，适用于儿童/青少年患者及其向成人护理的过渡、麻醉评估以及与全科医生持续共享护理的建议，作为一种慢性病管理途径。
