Rajagopal Selvi, Wickham Edmond P, Reid Tirissa J, Brittan Dana R, Korner Judith, Gudzune Kimberly A
Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
Obes Pillars. 2025 Jan 7;13:100157. doi: 10.1016/j.obpill.2025.100157. eCollection 2025 Mar.
While clinical practice habits vary by patient, physician and clinic factors in primary care, limited research has examined whether differences exist in obesity medicine. Our objective was to compare practice habits by such factors among obesity medicine physicians certified by the American Board of Obesity Medicine (ABOM).
We conducted secondary analyses of cross-sectional data from the 2023 ABOM Practice Analysis Validation Survey. We included three obesity medicine practice habits - prescribing anti-obesity medications (AOMs), off-label prescribing of medications for weight reduction, and obesity medicine clinical practice hours (4-20 h/week versus >20 h/week). We included patient (patient population), physician (primary medical specialty, years of obesity medicine experience) and clinic factors (practice setting, geographic catchment, accepts insurance for obesity care). We conducted bivariate analyses using Χ tests.
Among 565 ABOM-certified physicians, 71.5 % had primary medical specialties within primary care and 9.2 % predominantly treated children/adolescents with obesity. Overall, 97.5 % prescribed AOMs and 85.1 % prescribed off-label medications for weight reduction. Fewer physicians who predominantly treated children/adolescents prescribed AOMs compared to physicians with no or limited treatment of children (88.5 % versus 98.4 % and 98.5 %, respectively; p < 0.001). Overall, 41.4 % reported practicing obesity medicine >20 h/week, which was more likely to occur as years of obesity medicine experience increased (i.e., 21.9 % among physicians with 1-2 years of experience versus 58.5 % with 10+ years; p < 0.001). No significant differences in practice habits occurred by primary medical specialty, practice setting, geographic catchment, or accepting insurance.
Our findings may suggest that ABOM-certified physicians have consistent obesity medication prescribing practices regardless of physician or clinic factors, which may be particularly important to patients seeking pharmacologic treatment. Most ABOM-certified physicians who predominantly treat children/adolescents prescribe obesity medications. These current rates are relatively higher than prior findings among pediatric ABOM-certified physicians, which might help support pharmacologic access for pediatric patients.
虽然初级保健中的临床实践习惯因患者、医生和诊所因素而异,但针对肥胖医学领域是否存在差异的研究有限。我们的目标是比较美国肥胖医学委员会(ABOM)认证的肥胖医学医生在这些因素方面的实践习惯。
我们对2023年ABOM实践分析验证调查的横断面数据进行了二次分析。我们纳入了三种肥胖医学实践习惯——开具抗肥胖药物(AOMs)、药物减重的超说明书用药以及肥胖医学临床实践时长(每周4 - 20小时与超过20小时)。我们纳入了患者因素(患者群体)、医生因素(主要医学专业、肥胖医学经验年限)和诊所因素(实践场所、地理服务范围、是否接受肥胖治疗保险)。我们使用卡方检验进行双变量分析。
在565名ABOM认证的医生中,71.5%的医生主要医学专业属于初级保健领域,9.2%的医生主要治疗肥胖儿童/青少年。总体而言,97.5%的医生开具AOMs,85.1%的医生开具超说明书的减重药物。与未治疗或很少治疗儿童的医生相比,主要治疗儿童/青少年的医生开具AOMs的比例较低(分别为88.5%、98.4%和98.5%;p < 0.001)。总体而言,41.4%的医生报告每周从事肥胖医学工作超过20小时,随着肥胖医学经验年限的增加,这种情况更有可能发生(即1 - 2年经验的医生中为21.9%,10年以上经验的医生中为58.5%;p < 0.001)。主要医学专业、实践场所、地理服务范围或是否接受保险在实践习惯方面没有显著差异。
我们的研究结果可能表明,无论医生或诊所因素如何,ABOM认证的医生在肥胖药物处方实践上具有一致性,这对于寻求药物治疗的患者可能尤为重要。大多数主要治疗儿童/青少年的ABOM认证医生会开具肥胖药物。目前这些比例相对高于之前儿科ABOM认证医生的研究结果,这可能有助于支持儿科患者获得药物治疗。