Department of Surgery and Center for Obesity Medicine and Metabolic Performance, University of Texas McGovern Medical School, Houston, TX, USA.
Boston Orthopaedic and Spine, Boston, MA, USA.
Postgrad Med. 2021 Nov;133(8):979-987. doi: 10.1080/00325481.2021.1982588. Epub 2021 Oct 25.
Obesity is a major risk factor for development and worsening of osteoarthritis (OA). Managing obesity with effective weight loss strategies can improve patients' OA symptoms, functionality, and quality of life. However, little is known about the clinical journey of patients with both OA and obesity. This study aimed to map the medical journey of patients with OA and obesity by characterizing the roles of health care providers, influential factors, and how treatment decisions are made.
A cross-sectional study was completed with 304 patients diagnosed with OA and a body mass index (BMI) of ≥30 kg/m and 101 primary care physicians (PCPs) treating patients who have OA and obesity.
Patients with OA and obesity self-manage their OA for an average of five years before seeking care from a healthcare provider, typically a PCP. Upon diagnosis, OA treatments were discussed; many (61%) patients reported also discussing weight/weight management. Despite most (74%) patients being at least somewhat interested in anti-obesity medication, few (13%) discussed this with their PCP. Few (12%) physicians think their patients are motivated to lose weight, but almost all (90%) patients have/are currently trying to lose weight. Another barrier to effective obesity management in patients with OA is the low utilization of clinical guidelines for OA and obesity management by PCPs.
As the care coordinator of patients with OA and obesity, PCPs have a key role in supporting their patients in the treatment journey; obesity management guidelines can be valuable resources.
肥胖是骨关节炎（OA）发展和恶化的一个主要危险因素。通过有效的减肥策略来管理肥胖，可以改善患者的 OA 症状、功能和生活质量。然而，对于 OA 和肥胖并存的患者的临床治疗过程知之甚少。本研究旨在通过描述医疗保健提供者的角色、影响因素以及治疗决策的制定方式，来描绘 OA 和肥胖患者的医疗之旅。
对 304 名诊断为 OA 且 BMI≥30kg/m2的患者和 101 名治疗 OA 和肥胖患者的初级保健医生（PCP）进行了横断面研究。
OA 和肥胖患者在寻求医疗保健提供者治疗之前，平均自行管理 OA 五年，通常是 PCP。诊断后，会讨论 OA 治疗方案；许多（61%）患者报告还讨论了体重/体重管理。尽管大多数（74%）患者对减肥药至少有些感兴趣，但很少（13%）与他们的 PCP 讨论过。很少（12%）的医生认为他们的患者有减肥的动力，但几乎所有（90%）的患者都有/正在尝试减肥。影响 OA 患者肥胖管理效果的另一个障碍是 PCP 对 OA 和肥胖管理临床指南的低利用率。
作为 OA 和肥胖患者的护理协调员，PCP 在支持患者的治疗过程中发挥着关键作用；肥胖管理指南可以是有价值的资源。
