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超重或肥胖人群的肥胖症药物治疗前景

Obesity Medication Treatment Perspectives Among People with Overweight or Obesity.

作者信息

Ostrominski John W, Chhibber Anindit, Kuti Effie L, Clark Brendan, Donato Bonnie M K

机构信息

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

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

出版信息

Patient Prefer Adherence. 2025 Sep 13;19:2887-2899. doi: 10.2147/PPA.S555622. eCollection 2025.

DOI:10.2147/PPA.S555622
PMID:40969562
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12442898/
Abstract

BACKGROUND

Obesity is a complex, chronic condition associated with multiple health complications. While obesity medications (OMs), particularly GLP-1 receptor agonists (GLP-1RAs), have demonstrated significant clinical benefits, real-world insights into patient experiences with these therapies remain limited. This study evaluated patients' behaviors and experiences with OMs, including their financial impact; and aimed to identify key decision points for seeking and receiving treatment with OMs.

METHODS

Individuals were recruited from a national database to complete a 20-minute online survey between July 8 and July 18, 2024. Eligible participants were adults aged 21 years or older with a body mass index (BMI) of ≥30 kg/m, or ≥27 kg/m with at least one obesity-related complication (ORC) and were currently using an OM. Participants reported their experiences with OMs, motivations and barriers for treatment, challenges, interactions with HCPs and financial challenges with OMs.

RESULTS

100 people with obesity (PwO) participated in the survey. The median age of the respondents was 46 years. Most PwO (94%) had at least one comorbidity in addition to overweight/obesity, and 58% were more concerned about obesity compared with other health conditions. Most PwO (91%) were currently using GLP-1RAs and had previously attempted a median of 3 unique weight management strategies prior to OM initiation. Primary drivers for OM initiation were long-term health improvement (58%) and functional enhancement (53%). Major barriers included insurance restrictions (38%), concerns about side effects (37%), and cost (31%). While on OMs, most (88%) PwO reported a positive experience, citing significant benefits on body weight and appetite reduction; 9% were neutral and 3% reported a negative experience. Participants with longer durations of reported treatment more often reported positive experiences (79% among those with ≥6 months of therapy; 51% among those with <6 months of therapy). The study also found that 56% of PwO expected to be on their current OM for a limited period, with 20% anticipating less than a year and 28% anticipating less than two years. The anticipated treatment duration among PwO varied with reported out-of-pocket (OOP) costs. Communication with HCPs frequently addressed side effects and administration, but discussions about treatment duration and lifestyle integration were less consistent.

CONCLUSION

This study highlights the multifaceted experiences of PwO in managing obesity, particularly regarding OM use. The findings underscore the importance of early intervention, robust patient-provider communication, equitable access, and financial support to optimize treatment outcomes. Addressing systemic barriers, stigma, education, and access challenges will be essential to maximize the utility of obesity pharmacotherapy in clinical practice.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf2c/12442898/f074733b3db4/PPA-19-2887-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf2c/12442898/335aede1798b/PPA-19-2887-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf2c/12442898/f074733b3db4/PPA-19-2887-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf2c/12442898/335aede1798b/PPA-19-2887-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf2c/12442898/f074733b3db4/PPA-19-2887-g0002.jpg
摘要

背景

肥胖是一种复杂的慢性疾病,与多种健康并发症相关。虽然肥胖症药物(OMs),尤其是胰高血糖素样肽-1受体激动剂(GLP-1RAs)已显示出显著的临床益处,但对于患者使用这些疗法的实际体验的了解仍然有限。本研究评估了患者使用OMs的行为和体验,包括其经济影响;并旨在确定寻求和接受OMs治疗的关键决策点。

方法

从一个全国性数据库中招募个体,于2024年7月8日至7月18日完成一项20分钟的在线调查。符合条件的参与者为年龄在21岁及以上、体重指数(BMI)≥30 kg/m²,或BMI≥27 kg/m²且患有至少一种肥胖相关并发症(ORC)且目前正在使用OMs的成年人。参与者报告了他们使用OMs的经历、治疗的动机和障碍、挑战、与医疗保健提供者(HCPs)的互动以及使用OMs的经济挑战。

结果

100名肥胖患者(PwO)参与了调查。受访者的中位年龄为46岁。大多数PwO(94%)除超重/肥胖外至少有一种合并症,58%的人相比其他健康状况更担心肥胖问题。大多数PwO(91%)目前正在使用GLP-1RAs,并且在开始使用OMs之前平均尝试过3种独特的体重管理策略。开始使用OMs的主要驱动因素是长期健康改善(58%)和功能增强(53%)。主要障碍包括保险限制(38%)、对副作用的担忧(37%)和费用(31%)。在使用OMs期间,大多数(88%)PwO报告了积极的体验,称对体重减轻和食欲降低有显著益处;9%为中性体验,3%报告了负面体验。报告治疗时间较长的参与者更常报告积极体验(治疗≥6个月的参与者中为79%;治疗<6个月的参与者中为51%)。研究还发现,56%的PwO预计在有限时间内使用当前的OMs,20%预计使用时间不到一年,28%预计使用时间不到两年。PwO预期的治疗持续时间因报告的自付费用(OOP)而异。与HCPs的沟通经常涉及副作用和给药,但关于治疗持续时间和生活方式整合的讨论则不太一致。

结论

本研究突出了PwO在管理肥胖方面的多方面体验,特别是在使用OMs方面。研究结果强调了早期干预、强有力的医患沟通、公平获取和经济支持对于优化治疗结果的重要性。解决系统性障碍、耻辱感、教育和获取挑战对于在临床实践中最大限度地发挥肥胖药物治疗的效用至关重要。

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