Effectiveness of Combining Antiobesity Medication With an Employer-Based Weight Management Program for Treatment of Obesity: A Randomized Clinical Trial
| Autor: | Abhilasha Ramasamy, Bartolome Burguera, Elena Borukh, B. Gabriel Smolarz, Marcio L. Griebeler, Bruce Rogen, Kevin M. Pantalone, James B. Young, Brian J. Harty, Merav Baz Hecht |
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| Rok vydání: | 2021 |
| Předmět: |
Topiramate
Adult Male medicine.medical_specialty Occupational Health Services Health Services Accessibility law.invention Randomized controlled trial law Weight loss Weight management Weight Loss Clinical endpoint medicine Humans Obesity Life Style Work Performance Ohio Original Investigation business.industry Body Weight General Medicine Middle Aged Combined Modality Therapy United States Weight Reduction Programs Orlistat Treatment Outcome Phentermine Physical therapy Patient Compliance Female Anti-Obesity Agents medicine.symptom business Body mass index medicine.drug Program Evaluation |
| Zdroj: | JAMA Netw Open |
| ISSN: | 2574-3805 |
| Popis: | IMPORTANCE: The clinical efficacy of antiobesity medications (AOMs) as adjuncts to lifestyle intervention is well characterized, but data regarding their use in conjunction with workplace wellness plans are lacking, and coverage of AOMs by US private employers is limited. OBJECTIVE: To determine the effect of combining AOMs with a comprehensive, interdisciplinary, employer-based weight management program (WMP) compared with the WMP alone on weight loss, treatment adherence, and work productivity and limitations. DESIGN, SETTING, AND PARTICIPANTS: This 1-year, single-center, open-label, parallel-group, real-world, randomized clinical trial was conducted at the Cleveland Clinic’s Endocrinology and Metabolism Institute in Cleveland, Ohio, from January 7, 2019, to May 22, 2020. Participants were adults with obesity (body mass index [BMI; calculated as weight in kilograms divided by height in meters squared] ≥30) enrolled in the Cleveland Clinic Employee Health Plan. INTERVENTIONS: In total, 200 participants were randomized 1:1, 100 participants to WMP combined with an AOM (WMP+Rx), and 100 participants to WMP alone. The WMP was the Cleveland Clinic Endocrinology and Metabolism Institute’s employer-based integrated medical WMP implemented through monthly multidisciplinary shared medical appointments. Participants in the WMP+Rx group initiated treatment with 1 of 5 US Food and Drug Administration–approved medications for chronic weight management (orlistat, lorcaserin, phentermine/topiramate, naltrexone/bupropion, and liraglutide, 3.0 mg) according to standard clinical practice. MAIN OUTCOMES AND MEASURES: The primary end point was the percentage change in body weight from baseline to month 12. RESULTS: The 200 participants were predominately (177 of 200 [88.5%]) women, had a mean (SD) age of 50.0 (10.3) years, and a mean (SD) baseline weight of 105.0 (19.0) kg. For the primary intention-to-treat estimand, the estimated mean (SE) weight loss was −7.7% (0.7%) for the WMP+Rx group vs −4.2% (0.7%) for the WMP group, with an estimated treatment difference of −3.5% (95% CI, −5.5% to −1.5%) (P |
| Databáze: | OpenAIRE |
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