Developing Integrated Clinical Pathways for the Management of Clinically Severe Adult Obesity: a Critique of NHS England Policy.
Developing Integrated Clinical Pathways for the Management of Clinically Severe Adult Obesity: a Critique of NHS England Policy.
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开发临床严重成人肥胖症管理的综合临床路径：英国NHS政策的批判。
DOI：
10.1007/s13679-020-00416-8
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发表时间：
2020-12
影响因子：
8.8
通讯作者：
Tahrani AA
中科院分区：
文献类型：
--
作者：
Hazlehurst JM;Logue J;Parretti HM;Abbott S;Brown A;Pournaras DJ;Tahrani AA
肥胖症的预防和治疗途径是有据可查的，但肥胖症的患病率正在上升，获得治疗（包括减肥手术）的机会有限。本综述旨在评估目前英国肥胖管理的综合临床路径，并确定主要挑战。第2级（基于社区的生活方式干预）和第3级（专家体重管理服务）的证据有限，它如何促进护理和改善第4级的结果仍然不确定。治疗途径的可及性、治疗途径的僵化、治疗结果的不确定性和体重污名化似乎是改善护理的主要障碍。必须更加重视获得有效治疗、治疗灵活性、消除污名和确保治疗效果，包括长期健康成果。预防和治疗都应得到重视，但应被视为基本上是分开的途径。需要一个简化的体重管理系统，以允许灵活性和个性化护理的提供，包括为那些需要的人提供减肥手术后护理。
Pathways for obesity prevention and treatment are well documented, yet the prevalence of obesity is rising, and access to treatment (including bariatric surgery) is limited. This review seeks to assess the current integrated clinical pathway for obesity management in England and determine the major challenges. Evidence for tier 2 (community-based lifestyle intervention) and tier 3 (specialist weight management services) is limited, and how it facilitates care and improve outcomes in tier 4 remains uncertain. Treatment access, rigidity in pathways, uncertain treatment outcomes and weight stigma seems to be major barriers to improved care. More emphasis must be placed on access to effective treatments, treatment flexibility, addressing stigma and ensuring treatment efficacy including long-term health outcomes. Prevention and treatment should both receive significant focus though should be considered to be largely separate pathways. A simplified system for weight management is needed to allow flexibility and the delivery of personalized care including post-bariatric surgery care for those who need it.
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影响因子：
5.8
作者：
Caterson, Ian D.;Alfadda, Assim A.;Halford, Jason C. G.
通讯作者：
Halford, Jason C. G.
影响因子：
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168.9
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通讯作者：
Jebb, Susan A.
影响因子：
2.9
作者：
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通讯作者：
Ahmed, Ahmed R.