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在全科医疗中管理新一波的减肥药物:一项定性研究。

Managing the new wave of weight loss medication in general practice: A qualitative study.

机构信息

The Danish National Center for Obesity, Aarhus, Denmark.

Department of Public Health, Aarhus University, Aarhus, Denmark.

出版信息

Clin Obes. 2024 Jun;14(3):e12666. doi: 10.1111/cob.12666. Epub 2024 Apr 25.

Abstract

In early 2023, a new type of weight loss medication, Wegovy (semaglutide), was made available in Denmark. Both subsequent media coverage and public demand were huge. Wegovy is only available by prescription, primarily via general practitioners. However, there is very little knowledge about how healthcare professionals (HCPs) in general practice might deal with the great demand for and attention surrounding a new weight loss drug. The aim of this qualitative study was, therefore, to explore how Wegovy is managed and negotiated in general practice, particularly in terms of prescribing and follow-up. We conducted a focused ethnography study based on direct observation of consultations and both formal and informal interviews with seven doctors and four nurses from three general practices in Denmark. Using discourse analysis, we identified four central discourses revolving around trust in medicine, individual responsibility for health, the cost of weight loss medication, and the importance of shared decision-making. This study shows that the availability of a new, sought-after weight loss medication presents both opportunities and challenges for HCPs in general practice. The management of Wegovy involves numerous factors, including medical, economic, organizational, interpersonal and moral concerns.

摘要

2023 年初,一种新型减肥药——Wegovy(司美格鲁肽)在丹麦上市。随后,媒体的报道和公众的需求都非常大。Wegovy 只能凭处方购买,主要通过全科医生。然而,对于全科医生在面对新减肥药的巨大需求和关注时,如何处理这些问题,人们知之甚少。因此,本定性研究旨在探讨 Wegovy 在全科实践中的管理和协商情况,特别是在处方和随访方面。我们进行了一项基于丹麦三个全科实践中七名医生和四名护士的直接观察咨询以及正式和非正式访谈的聚焦民族志研究。通过话语分析,我们确定了四个围绕医学信任、健康的个人责任、减肥药物成本以及共同决策重要性的核心话语。本研究表明,一种新的、备受追捧的减肥药的出现,为全科医生提供了机遇,也带来了挑战。Wegovy 的管理涉及到许多因素,包括医疗、经济、组织、人际和道德方面的考虑。

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