Anti-obesity drug therapy in clinical practice: Evidence of a poor prescriptive attitude - 18/06/20
, Michelangelo Rottura a, Natasha Irrera a, Letteria Minutoli a, Alessandra Bitto a, Maria Antonietta Barbieri a, Giuseppe Cicala a, Anna Mecchio b, Giovanni Pallio a, Sebastiano Marino a, Giacomo Picciolo b, Domenica Altavilla b, Vincenzo Arcoraci aBienvenue sur EM-consulte, la référence des professionnels de santé.
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Graphical abstract |
Highlights |
• | Anti-obesity drugs prescriptions were evaluated among general practitioners (GPs). |
• | 830 out of 12,388 patients included in the study had a diagnosis of obesity. |
• | Most of them were eligible for a drug therapy, as suggested by available guideline. |
• | No anti-obesity drug prescription was found in the time frame of the study. |
• | There’s a block to the prescription of anti-obesity drugs by GPs that merits advise. |
Abstract |
Obesity is a worldwide growing problem for the health care systems and its treatment is strongly recommended. Orlistat, naltrexone/bupropion, and liraglutide are approved for weight loss in Italy in patients with a Body Mass Index (BMI) ≥ 30 kg/m2 or ≥ 27 kg/m2 with concomitant diseases. However, the prescription of these drugs is significantly low worldwide. General practitioners (GPs) play a key role in the early diagnosis and appropriate management of obesity. The aim of the study was to investigate the management of obesity and the prescriptive attitude of anti-obesity drugs in a general practice setting.
All patients registered in lists of 8 GPs with a recorded diagnosis of obesity or BMI values ≥ 30 kg/m2 in the period 2017–2018, were recruited. A descriptive analysis of demographic and clinical characteristic was carried out. The Spearman’s correlation rank test was applied to identify correlations between BMI and all the variables of interest.
Among 1301 obese patients, only 66.1 % had been diagnosed and 29.4 % had no registered BMI value. Patients with recorded BMI, were overweight (7.8 %) or in the obesity class I (38.8 %), class II (14.1 %), and class III (7.1 %), respectively.
The obese patients (class 1–3) were older [66 (55–76) vs 49 (32–59); p < 0.01], and had more concurrent diseases [5 (3−8) vs 4 (2–6); p < 0.01] than patients who reached a BMI < 30 Kg/m2. Moreover, most of obese were high cardiovascular risk (HCVr) patients (67.0 % vs 31.9 %; p < 0.01). The BMI was directly related to age (rs 0.14; p < 0.01), diabetes (rs 0.19; p < 0.01), hypertension (rs 0.14; p < 0.01), heart failure (rs 0.09; p < 0.01), HCVr (rs 0. 12; p < 0.01) and number of comorbidities (rs 0.08; p = 0.01). No prescriptions of orlistat or naltrexone/bupropion were found. Liraglutide was prescribed only in 7 patients because of the concomitant presence of diabetes.
Our results suggest a low adherence to guide line recommendations for obesity management and confirm an under-prescription of anti-obesity drugs in Italy.
Le texte complet de cet article est disponible en PDF.Keywords : General practice, Pharmacotherapy, Obesity, Prescription
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Vol 128
Article 110320- août 2020 Retour au numéro
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