Baalmann Angela R, Norton Melissa C, Gadbois-Mincks Natalie R, Ofei-Dodoo Samuel, Presnell Erica N
Fred Wilson School of Pharmacy High Point North Carolina USA.
Ascension Via Christi Hospitals Wichita Kansas USA.
Obes Sci Pract. 2024 Oct 1;10(5):e70011. doi: 10.1002/osp4.70011. eCollection 2024 Oct.
Effective, evidence-based obesity treatment is needed, which often involves use of anti-obesity medications (AOMs). Data on the breadth and quality of guideline-directed obesity treatment implementation in primary care remain limited. This study aimed to assess primary care clinicians' agreement with and knowledge of guideline-directed obesity treatment, as well as to assess the health status of persons with obesity and their use of AOMs.
This multimethod study included a prospective survey of primary care clinicians, utilizing a questionnaire that measured agreement on a 5-point Likert scale and knowledge via multiple choice questions. A retrospective analysis was also performed of patient data collected between 30 June 2016 and 30 June 2020 from primary care clinics in the Midwest.
Data were analyzed from 27 clinician survey responders, finding agreement toward all measured areas, however less strong for chronic AOM use and resource allocation. The survey identified multiple gaps in knowledge. Researchers assessed 5656 baseline encounters and 2941 corresponding follow-up encounters. Analysis revealed ≥50% of the total patients experienced persistently uncontrolled obesity (mean body mass index of ≥40 kg/m) and weight-related complications. Low rates (≤10%) of AOM use in clinically eligible patients were shown, with phentermine monotherapy being the most commonly used.
Clinicians agree with guideline-directed obesity treatment. Persons with obesity who are poorly controlled identify an opportunity for patient care improvement.
需要有效的、基于证据的肥胖症治疗方法,这通常涉及使用抗肥胖药物(AOMs)。关于初级保健中指南指导的肥胖症治疗实施的广度和质量的数据仍然有限。本研究旨在评估初级保健临床医生对指南指导的肥胖症治疗的认同度和了解程度,以及评估肥胖症患者的健康状况及其对AOMs的使用情况。
这项多方法研究包括对初级保健临床医生的前瞻性调查,使用一份在5点李克特量表上测量认同度并通过多项选择题测量知识的问卷。还对2016年6月30日至2020年6月30日期间从中西部初级保健诊所收集的患者数据进行了回顾性分析。
对27名临床医生调查回复者的数据进行了分析,发现对所有测量领域都有认同,但对慢性AOM使用和资源分配的认同度较低。该调查发现了多个知识空白。研究人员评估了5656次基线就诊和2941次相应的随访就诊。分析显示,≥50%的患者经历了持续性肥胖控制不佳(平均体重指数≥40kg/m²)和与体重相关的并发症。在符合临床条件的患者中,AOM的使用率较低(≤10%),其中苯丁胺单药治疗是最常用的。
临床医生认同指南指导的肥胖症治疗。肥胖控制不佳的患者为改善患者护理提供了机会。