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

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity Pub Date : 2024-12-18 DOI:10.1002/oby.24186

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

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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/m² or BMI 27–29.9 kg/m² 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/m²), 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/m². 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.

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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卫生保健系统的见解。

目的：本研究的目的是描述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（ORCs）的患病率、抗肥胖药物（AOM）的资格和处方实践。方法：通过对2018年至2022年马萨诸塞州波士顿多中心布里格姆医疗保健系统（Mass General Brigham health care system, Boston, Massachusetts）的横断面分析，确定了符合AOMs （BMI≥30 kg/m2或BMI 27-29.9 kg/m2且ORC≥1）条件的成年人。在符合aom条件的患者中，评估了aom处方被批准用于长期体重管理的流行程度。结果：2,469,474名成人(平均[SD]，年龄53岁；57%的女性;BMI 28.1 [6.3] kg/m2)，共有1,110,251例（45.0%）符合AOMs。其中，69.4%（占总队列的31.2%）的BMI≥30 kg/m2。在所有符合条件的患者中，15214例（1.4%）患者开了AOM处方，其中女性、年龄较小、BMI较高、有商业保险、ORC负担较大与AOM处方的高患病率相关。肌肉骨骼疾病（54%）是最常见的ORCs， 62%的患者观察到≥2个ORCs。利拉鲁肽3.0 mg和semaglutide 2.4 mg是最常用的AOMs（分别占所有AOMs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标准，但只有1%的患者符合aom处方。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Obesity 医学-内分泌学与代谢

CiteScore

11.70

自引率

1.40%

发文量

261

审稿时长

2-4 weeks

期刊介绍： Obesity is the official journal of The Obesity Society and is the premier source of information for increasing knowledge, fostering translational research from basic to population science, and promoting better treatment for people with obesity. Obesity publishes important peer-reviewed research and cutting-edge reviews, commentaries, and public health and medical developments.