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澳大利亚公共资助的专科肥胖症服务持续就诊的预测因素。

Predictors of ongoing attendance at an Australian publicly funded specialist obesity service.

作者信息

Brightman Louise, Huang Hsin-Chia Carol, Georgousopoulou Ekavi

机构信息

Obesity Management Sevice Canberra Health Services (CHS) Canberra Australian Capital Territory (ACT) Australia.

School of Medicine and Psychology Australian National University (ANU) Canberra ACT Australia.

出版信息

Obes Sci Pract. 2024 Oct 30;10(6):e70010. doi: 10.1002/osp4.70010. eCollection 2024 Dec.

Abstract

INTRODUCTION

There is a demand for publicly funded specialist obesity services in Australia. A range of factors can impact on patient attendance which can result in poorer health outcomes.

OBJECTIVE

To identify patient factors that predict ongoing in-person attendance following initial medical assessment at the Canberra Obesity Management Service.

METHODS

Data were collated from two retrospective reviews (July 2016-June 2017 and July 2018-June 2019). Predictive modeling was used to determine the likelihood of ongoing attendance.

RESULTS

A total of 396 patients were identified. Mean age was 45.4 years (SD 13.1), mean weight was 139.5 kg (SD 27.8) and mean Body Mass Index was 49.87 kg/m (SD 8.7). Demographics and anthropometrics were not predictive of ongoing attendance. Patients with a higher comorbidity burden were more likely to continue attending ( < 0.001). Patients with obstructive sleep apnea (OSA) were 4.9 times more likely to continue attending ( < 0.001). Hypertension was more common among patients who continued attending ( = 0.005); however, this relationship was no longer significant when using a multi-adjusted model. Comorbid depression and/or anxiety diagnoses were not predictive of ongoing attendance although the -value for anxiety severity classification approached significance.

CONCLUSIONS

Findings are consistent with existing evidence linking OSA and attendance at specialist obesity services. Hypertension was predictive of ongoing attendance and warrants further research. Determining if anxiety is a true barrier to attendance at specialist obesity services may have implications in terms of optimizing diagnosis and treatment prior to referral or in the early stages of obesity management.

摘要

引言

澳大利亚对由公共资金资助的专科肥胖症服务有需求。一系列因素会影响患者就诊,进而可能导致健康状况更差。

目的

确定在堪培拉肥胖症管理服务中心进行初次医学评估后,能预测患者持续亲自就诊的因素。

方法

数据来自两项回顾性研究(2016年7月至2017年6月以及2018年7月至2019年6月)。采用预测模型来确定持续就诊的可能性。

结果

共识别出396名患者。平均年龄为45.4岁(标准差13.1),平均体重为139.5千克(标准差27.8),平均体重指数为49.87千克/平方米(标准差8.7)。人口统计学和人体测量学指标无法预测持续就诊情况。合并症负担较重的患者更有可能继续就诊(<0.001)。患有阻塞性睡眠呼吸暂停(OSA)的患者继续就诊的可能性高4.9倍(<0.001)。高血压在继续就诊的患者中更为常见(=0.005);然而,在使用多变量调整模型时,这种关系不再显著。合并抑郁症和/或焦虑症的诊断不能预测持续就诊情况,尽管焦虑严重程度分类的P值接近显著性。

结论

研究结果与将OSA与专科肥胖症服务就诊情况相联系的现有证据一致。高血压可预测持续就诊情况,值得进一步研究。确定焦虑是否是专科肥胖症服务就诊的真正障碍,可能对在转诊前或肥胖症管理早期优化诊断和治疗有影响。

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