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超重和肥胖的当代治疗模式:来自麻省总医院布莱根医疗保健系统的见解

Contemporary treatment patterns of overweight and obesity: insights from the Mass General Brigham health care system.

作者信息

Ostrominski John W, Wagholikar Kavishwar B, Olsson Kelly, Unlu Ozan, Zelle David, Kumar Sanjay, Smith Austen M, Toliver Joshua C, Michalak Wojciech, Fabricatore Anthony, Hartaigh Bríain Ó, Baer Heather J, Cannon Christopher P, Apovian Caroline M, Fisher Naomi D L, Plutzky Jorge, Scirica Benjamin M, Blood Alexander J

机构信息

Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.

Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Boston, Massachusetts, USA.

出版信息

Obesity (Silver Spring). 2025 Feb;33(2):365-384. doi: 10.1002/oby.24186. Epub 2024 Dec 18.

Abstract

OBJECTIVE

The objective of this study was to describe the prevalence of obesity, obesity-related conditions (ORCs), and antiobesity medication (AOM) eligibility and prescribing practice among eligible patients in a large health care system.

METHODS

In this cross-sectional analysis of the multicenter Mass General Brigham health care system (Boston, Massachusetts) spanning 2018 to 2022, adults eligible for AOMs (BMI ≥ 30 kg/m or BMI 27-29.9 kg/m with ≥1 ORC) were identified. Among those AOM-eligible, the prevalence of prescriptions for AOMs approved for long-term weight management was evaluated.

RESULTS

Of 2,469,474 adults (mean [SD], age 53 [19] years; 57% female; BMI 28.1 [6.3] kg/m), a total of 1,110,251 (45.0%) were eligible for AOMs. Of these, 69.4% (31.2% of overall cohort) had BMI ≥ 30 kg/m. AOM prescription was observed in 15,214 (1.4%) of all eligible patients, with female sex, younger age, higher BMI, commercial insurance, and greater ORC burden associated with higher prevalence of AOM prescriptions. Musculoskeletal disorders (54%) were the most common ORCs, with ≥2 ORCs observed in 62% of patients. Liraglutide 3.0 mg and semaglutide 2.4 mg were the most frequently prescribed AOMs (58% and 34% of all AOMs, respectively).

CONCLUSIONS

Although nearly one-half of all patients in a large health care system were AOM-eligible by guidelines and regulatory labeling, only 1% of those who were eligible were prescribed AOMs.

摘要

目的

本研究的目的是描述在一个大型医疗保健系统中符合条件的患者中肥胖、肥胖相关疾病(ORC)的患病率,以及抗肥胖药物(AOM)的适用情况和处方实践。

方法

在对2018年至2022年多中心麻省总医院布莱根医疗保健系统(马萨诸塞州波士顿)进行的横断面分析中,确定了符合AOM条件的成年人(BMI≥30kg/m或BMI为27-29.9kg/m且患有≥1种ORC)。在那些符合AOM条件的患者中,评估了被批准用于长期体重管理的AOM处方的患病率。

结果

在2469474名成年人中(平均[标准差]年龄为53[19]岁;57%为女性;BMI为28.1[6.3]kg/m),共有1110251人(45.0%)符合AOM条件。其中,69.4%(占总队列的31.2%)的BMI≥30kg/m。在所有符合条件的患者中,有15214人(1.4%)开具了AOM处方,女性、年龄较小、BMI较高、商业保险以及ORC负担较重与AOM处方患病率较高相关。肌肉骨骼疾病(54%)是最常见的ORC,62%的患者患有≥2种ORC。3.0mg利拉鲁肽和2.4mg司美格鲁肽是最常开具的AOM(分别占所有AOM的58%和34%)。

结论

尽管根据指南和监管标签,大型医疗保健系统中近一半的患者符合AOM条件,但符合条件的患者中只有1%开具了AOM处方。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8415/11774016/d2493cc3cb43/OBY-33-365-g002.jpg

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