Bariatric treatments for adult obesity - Institute of Health Economics

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ABBREVIATIONSAll abbreviations that have been used in this report are listed below unless the abbreviation is wellknown, or it has been used only once, or it is a non-standard abbreviation used only in figures, tables,or appendices, in which case the abbreviation is defined in the figure legend or at the end of thetable.ACS American College of SurgeonsAEadverse eventAETMIS Agence d’évaluation des technologies et des modes d’intervention en santéAGB adjustable gastric bandingAHS Alberta Health ServicesAORN Association of periOperative Registered NursesASMBS American Society for Metabolic and Bariatric SurgeryAWMC Adult Weight Management ClinicBDD balanced deficit dietBIAbioelectrical impedance analysisBMI body mass indexBPblood pressureBPD biliopancreatic diversionBTbehavioural therapyBWbody weightCAD coronary artery diseaseCADTH Canadian Agency for Drugs and Technologies in HealthCBT cognitive behavioural therapyCCHS Canadian Community Health SurveyCCICanadian Classification of Health InterventionsCDC Centers for Disease Control and PreventionCEA cost-effectiveness analysisCHD coronary heart diseaseCHF congestive heart failureCIconfidence intervalCPG clinical practice guidelineCPIConsumer Price IndexBariatric treatments for adult obesity – March 2012xiii
CrICUACVADDBPDMDSEEWLFFDAGBGBPGIHbA1cHBGHDLHGHTAHrQoLICERIFSOIGTJBkgLLAGBLCDLDLLGBPLMLRYGBcredible intervalcost-utility analysiscerebrovascular accidentdietdiastolic blood pressurediabetes mellitusduodenal switchexerciseexcess weight lossfemaleFood and Drug Administrationgastric bandinggastric bypass (open procedure)glycemic indexglycesylated glucosehorizontal banded gastroplastyhigh-density lipoproteinhorizontal gastroplastyhealth technology assessmenthealth-related quality of lifeincremental cost-effectiveness ratioInternational Federation for the Surgery of Obesityimpaired glucose tolerancejejunoileal bypasskilogramlitrelaparoscopic adjustable gastric bandinglow-calorie dietlow-density lipoproteinlaparoscopic gastric bypasslifestyle modificationlaparoscopic Roux-en-Y gastric bypassBariatric treatments for adult obesity – March 2012xiv
Page 1 and 2: Alberta STE ReportBariatric treatme
Page 3 and 4: Alberta STE ReportBariatric treatme
Page 5 and 6: EXECUTIVE SUMMARYSocial and System
Page 7 and 8: Three surgical procedures—adjusta
Page 9: Costs of Bariatric Surgery and Pote
Page 12 and 13: Regulatory status .................
Page 14 and 15: TABLES AND FIGURESSection One: Soci
Page 18 and 19: LYMmMAMDMUHCNANHLBINHSNICENIHNNHNPH
Page 20 and 21: Bariatric physician: a licensed Doc
Page 22 and 23: High-density lipoprotein (HDL): a f
Page 24 and 25: Very-low-calorie diet (VLCD): a die
Page 26 and 27: Additional Internet searches were c
Page 28 and 29: This report addresses obesity in ad
Page 30 and 31: Many systemic factors have been ide
Page 32 and 33: Severe obesity is associated with d
Page 34 and 35: eport their height and under-report
Page 36 and 37: Also using self-reported data from
Page 38 and 39: An examination of overall obesity d
Page 40 and 41: Table S.2 presents the associationa
Page 42 and 43: • have multiple focal points and
Page 45 and 46: The main problem in any weight mana
Page 47: food, and a negative body image. As
Page 50 and 51: directly causes death. 61 To the ex
Page 52 and 53: The addition of a selected pharmaco
Page 54 and 55: lack of formal training in nutritio
Page 56 and 57: slightly more likely to have prescr
Page 58 and 59: selection criteria, have facilities
Page 60 and 61: Barriers to using appropriate baria
Page 62 and 63: Overview of adult obesityOver the p
Page 64 and 65: the need for regular physical activ
Page 66 and 67:
phenylpropanolamine/25. Sibutramine
Page 68 and 69:
Complianceand AdherenceDemand andut
Page 70 and 71:
Aetna Clinical PolicyBulletinswww.a
Page 72 and 73:
Overweight 123,821 172,971 157,623
Page 74 and 75:
REFERENCES1. 2006 Canadian clinical
Page 76 and 77:
34. Gostin LO. Fast and supersized:
Page 78 and 79:
69. Klarenbach S, Padwal R, Wiebe N
Page 80 and 81:
105. Hill JO, Thompson H, Wyatt H.
Page 82 and 83:
141. Ross R, Bradshaw AJ. The futur
Page 84 and 85:
172. Arkinson J, Ji H, Fallah S, Pe
Page 86 and 87:
This section will address a set of
Page 88 and 89:
dietary therapy is to reduce total
Page 90 and 91:
Additional benefits of exercise ove
Page 92 and 93:
medications that inhibit intestinal
Page 94 and 95:
Rimonabant may be considered for pa
Page 96 and 97:
Long-term complications are specifi
Page 98 and 99:
Devices used for bariatric surgeryH
Page 100 and 101:
Description of the Included Systema
Page 102 and 103:
AEs for sibutramineAs compared to a
Page 104 and 105:
Evidence on Efficacy/EffectivenessW
Page 106 and 107:
Table T.7: Effects of behavioural t
Page 108 and 109:
SurgeryDescription of the included
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follow-up time was 3 years. Results
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group as compared to the VBG group.
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The authors identified many methodo
Page 116 and 117:
The investigators pointed out that
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approximately 3 to 5 kilograms. For
Page 120 and 121:
for studies with a mean age of part
Page 122 and 123:
Examining whether use of any of the
Page 124 and 125:
Evidence from placebo-controlled cl
Page 126 and 127:
colorectal or gastroesophageal or f
Page 128 and 129:
Web of ScienceISI Interface License
Page 130 and 131:
AMA Clinical PracticeGuidelineswww.
Page 132 and 133:
critical appraisal of the included
Page 134 and 135:
APPENDIX T.B: EXCLUDED STUDIESTable
Page 136 and 137:
Padwal R, Li SK, Lau DC. Long-term
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Quality subsection 1: At least MEDL
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Quality subsection 5a:Study quality
Page 142 and 143:
Partially reported: The study types
Page 144 and 145:
Table T.C.1: Results of quality ass
Page 146 and 147:
Table T.C.1: Results of quality ass
Page 148 and 149:
APPENDIX T.D: CHARACTERISTICS OF SY
Page 150 and 151:
Table T.D.1: Characteristics of the
Page 152 and 153:
Page 154 and 155:
Page 156 and 157:
APPENDIX T.E: EVIDENCE TABLE ON SAF
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Serious surgical complicationsSurgi
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LSGmMAMDNAnssORQoLRCTRDRRRYGBSBPTGV
Page 162 and 163:
Table T.F.1-2: Weight loss - Behavi
Page 164 and 165:
Table T.F.1-4: Weight loss - Surger
Page 166 and 167:
Table T.F.2: Quality of life (QoL)
Page 168 and 169:
Curioni & Lourenco 2005 58Cholester
Page 170 and 171:
Table T.F.3-3: Risk factors/comorbi
Page 172 and 173:
Table T.F.3-5: Long-term effects of
Page 174 and 175:
Maciejewski et al., 2005 65Avenell
Page 176 and 177:
Table T.G.2: Effects of bariatric s
Page 178 and 179:
Table T.G.4: Effects of bariatric s
Page 180 and 181:
18. Cerulli J, Lomaestro BM, Malone
Page 182 and 183:
50. Health Canada Drug Product Data
Page 184 and 185:
SECTION THREE: ECONOMIC EVALUATIONC
Page 186 and 187:
Definition of bariatric surgical pa
Page 188 and 189:
etween surgical interventions, the
Page 190 and 191:
concluded that adding orlistat to L
Page 192 and 193:
Weight management program (WMP) ver
Page 194 and 195:
groups. Compared with standard care
Page 196 and 197:
Results from Analysis of Provincial
Page 198 and 199:
DiscussionThe objectives of the eco
Page 200 and 201:
surgical suites, and so on. The bud
Page 202 and 203:
APPENDIX E.A: LITERATURE SEARCH SUM
Page 204 and 205:
CRD Databases(DARE, HTA & NHS EED)h
Page 206 and 207:
Web of ScienceISI Interface License
Page 208 and 209:
NEOS Librarywww.library.ualberta.ca
Page 210 and 211:
Table E.A.2: Evidence table of revi
Page 212 and 213:
ResultHealth outcomesCostsMarginal
Page 214 and 215:
CostsMarginal analysisThe cost anal
Page 216 and 217:
Time Horizon/discount rateCurrency/
Page 218 and 219:
Objectivestudy perspective: society
Page 220 and 221:
Page 222 and 223:
Page 224 and 225:
S4Economic burden of obesityMean co
Page 226 and 227:
15. Lacey LA, Wolf A, O'shea D, Ern
Page 228 and 229:
Author Contribution StatementsPaula
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