Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institution, Baltimore, Maryland, USA.
Clin Obes. 2021 Feb;11(1):e12407. doi: 10.1111/cob.12407. Epub 2020 Sep 10.
Our objective was to determine the clinical services offered by American Board of Obesity Medicine (ABOM) Diplomates and whether guideline concordant services varied by clinical practice attributes. We conducted a cross-sectional analysis of the 2019 ABOM Diplomate survey (response rate 19.2%). Respondents (n = 494) self-reported services offered: nutrition, exercise, mental health, minimally invasive bariatric procedures, perioperative bariatric surgical care and FDA-approved anti-obesity medications. We graded concordance of services offered with three evidence-based obesity guidelines, and then conducted bivariate analyses comparing concordance by practice attributes. Most responding ABOM Diplomates offered nutrition (90.1%), exercise (67.8%) and mental health (76.7%). Few offered minimally invasive procedures (24.3%), and most provided perioperative surgical care (63.0%). Most (83.4%) prescribed FDA-approved medications-typically both short- and long-term agents (70.9%). Few Diplomates had low concordance with the American Heart Association/American College of Cardiology/The Obesity Society (AHA/ACC/TOS) guidelines (24.7%). Those who managed more obesity-related conditions and endorsed AHA/ACC/TOS guideline use had higher concordance with these recommendations. No differences in guideline concordance existed by population, clinical effort or location. We found similar findings regarding concordance with ) American Association of Clinical Endocrinologists/American College of Endocrinology and Obesity Medicine Association guidelines. In conclusion, most responding ABOM Diplomates offer evidence-based obesity medicine services. Clinicians may therefore have increased confidence in patient receipt of evidence-based care when referring to an ABOM Diplomate.
我们的目的是确定美国肥胖医学委员会(ABOM)认证医师提供的临床服务,以及指南一致的服务是否因临床实践特征而异。我们对 2019 年 ABOM 认证医师调查进行了横断面分析(应答率为 19.2%)。受访者(n=494)自我报告提供的服务:营养、运动、心理健康、微创减肥手术、围手术期减肥手术护理和美国食品和药物管理局批准的抗肥胖药物。我们根据三项基于证据的肥胖指南对提供的服务进行了分级,并对按实践特征进行比较的一致性进行了单变量分析。大多数接受调查的 ABOM 认证医师提供营养(90.1%)、运动(67.8%)和心理健康(76.7%)服务。微创程序的提供较少(24.3%),大多数提供围手术期手术护理(63.0%)。大多数(83.4%)开具美国食品和药物管理局批准的药物-通常是短期和长期药物(70.9%)。少数认证医师与美国心脏协会/美国心脏病学会/肥胖协会(AHA/ACC/TOS)指南的一致性较低(24.7%)。那些管理更多肥胖相关疾病并认可 AHA/ACC/TOS 指南使用的人,与这些建议的一致性更高。人群、临床工作或地点的指南一致性没有差异。我们发现,与美国临床内分泌医师协会/美国内分泌学会和肥胖医学协会指南的一致性也存在类似的发现。总之,大多数接受调查的 ABOM 认证医师提供基于证据的肥胖医学服务。因此,当向 ABOM 认证医师转介时,临床医生可能对患者接受基于证据的护理更有信心。