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加拿大肥胖症的管理与影响:对肥胖症患者及其医生的一项现实世界调查。

Management and impact of obesity in Canada: A real-world survey of people with obesity and their physicians.

作者信息

Glass Jennifer, Carter Sophie, Artime Esther, Higgins Victoria, Harrison Lewis, Leith Andrea, Lau David Cw, Patton Ian, Kuk Jennifer L

机构信息

Eli Lilly Canada, 130 King St. West, Suite 900, Toronto, ON, M5X 1B1, Canada.

Eli Lilly & Company, Av. Industria, 30, 28108, Alcobendas, Spain.

出版信息

Obes Pillars. 2025 Feb 28;14:100171. doi: 10.1016/j.obpill.2025.100171. eCollection 2025 Jun.

Abstract

BACKGROUND

Obesity is a chronic relapsing disease associated with multiple complications. This study described real-world demographic/clinical characteristics, including obesity-related complications (ORCs), prescribing rationale, and patient-reported outcome measures (PROMs) for adults living with obesity in Canada accessing treatment.

METHODS

This was a cross-sectional survey of physicians and consulting people with obesity (PwO) in Canada with retrospective data capture in a real-world setting. Canadian data were drawn between July and November 2022 from the multinational Adelphi Real World Obesity Disease Specific Programme™. Consulting PwO were required to be on a weight management program and/or have a current body mass index of ≥30 kg/m. Physicians completed questionnaires for the next 3-5 consecutive PwO seen in their routine clinical practice. A quota was applied for obesity management medication (OMM). PROMs including Work Productivity and Activity Impairment (WPAI) questionnaire were provided voluntarily by PwO. Analyses were descriptive.

RESULTS

Overall, 50 physicians (35 general practitioners, 15 endocrinologists) and 199 PwO were analyzed. More than 85 % of PwO had ≥1 ORC. The most common ORCs were hypertension, dyslipidemia, depression, and type 2 diabetes, and one-quarter to one-half of ORCs were not optimally controlled. Approximately two-thirds of the cohort were employed full-time, almost half had private insurance, and almost 70 % were classified as high socio-economic status. Mean number of weight-reduction attempts over the past 3 years was 2.9. Pharmacological treatment for obesity was common among those with ORCs. A general trend towards greater work impairment among people with ORCs than for PwO without ORCs was observed.

CONCLUSIONS

Among PwO participating in our study, ORCs were common, often uncontrolled, and their presence impacted the likelihood of obesity treatment and possibly impaired work productivity. Medical treatment for obesity was often delayed until ORCs developed, suggesting that preventative healthcare measures are not the norm for PwO in Canada. A large proportion of PwO had high socioeconomic status, suggesting that PwO who access treatment may not be representative of the overall population of PwO in Canada.

摘要

背景

肥胖是一种与多种并发症相关的慢性复发性疾病。本研究描述了加拿大接受治疗的肥胖成年人的真实世界人口统计学/临床特征,包括肥胖相关并发症(ORC)、处方依据和患者报告的结局指标(PROM)。

方法

这是一项对加拿大医生和肥胖咨询患者(PwO)的横断面调查,在真实环境中进行回顾性数据收集。加拿大的数据于2022年7月至11月从跨国阿德尔菲真实世界肥胖疾病特定项目™中获取。咨询的PwO必须参加体重管理计划和/或当前体重指数≥30kg/m²。医生为其常规临床实践中接下来连续诊治的3 - 5名PwO填写问卷。对肥胖管理药物(OMM)应用了配额。PwO自愿提供包括工作效率和活动受损(WPAI)问卷在内的PROM。分析为描述性分析。

结果

总体而言,分析了50名医生(35名全科医生,15名内分泌科医生)和199名PwO。超过85%的PwO有≥1种ORC。最常见的ORC是高血压、血脂异常、抑郁症和2型糖尿病,四分之一至二分之一的ORC未得到最佳控制。大约三分之二的队列成员全职工作,近一半有私人保险,近70%被归类为高社会经济地位。过去3年平均减肥尝试次数为2.9次。肥胖的药物治疗在有ORC的人群中很常见。观察到有ORC的人群比没有ORC的PwO在工作受损方面有更明显的总体趋势。

结论

在参与我们研究的PwO中,ORC很常见,往往未得到控制,其存在影响了肥胖治疗的可能性,并可能损害工作效率。肥胖的药物治疗通常会推迟到出现ORC时,这表明预防性医疗措施在加拿大的PwO中并非常态。很大一部分PwO具有高社会经济地位,这表明接受治疗的PwO可能不代表加拿大PwO的总体人群。

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