Bariatric treatments for adult obesity - Institute of Health Economics

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Author Contribution StatementsPaula Corabian contributed to study conception and design, data analysis and interpretation, andapproved the final version for publication.Bing Guo contributed to study conception and design, data analysis and interpretation, and approvedthe final version for publication.Christa Harstall contributed to study conception and design, revision of manuscript for criticalcontent, and approved the final version for publication.Charles Yan contributed to study conception and design, statistical analysis, economic expert reviewof the literature, revision of manuscript for critical content, and approved the final version forpublication.Anderson (Andy) Chuck contributed to study conception and design, statistical analysis, economicexpert review of the literature, manuscript preparation, and approved the final version forpublication.Bariatric treatments for adult obesity 204
This report summarizes available key information on the use ofbariatric treatments for adult obesity in Alberta and North America(mainly Canada). This analysis was intended to describe the profileof adult obesity (definition, progression, epidemiology, andpopulation dynamics of affected individuals in Alberta and inCanada) and patterns of care for this condition (focusing onbariatric treatments recommended by evidence-based clinicalpractice guidelines), as well as to identify potential inequities inhealth status or care across population groups. Also consideredwere social factors associated with the use of multidisciplinaryprograms involving bariatric treatments for adult obesity in Alberta.Institute of Health Economics1200 – 10405 Jasper AvenueEdmonton AB Canada T5J 3N4Tel. 780.448.4881 Fax. 780.448.0018info@ihe.cawww.ihe.caISBN 978-1-926929-02-6 (on-line)
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Alberta STE ReportBariatric treatme
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Alberta STE ReportBariatric treatme
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EXECUTIVE SUMMARYSocial and System
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Three surgical procedures—adjusta
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Costs of Bariatric Surgery and Pote
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Regulatory status .................
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TABLES AND FIGURESSection One: Soci
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ABBREVIATIONSAll abbreviations that
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LYMmMAMDMUHCNANHLBINHSNICENIHNNHNPH
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Bariatric physician: a licensed Doc
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High-density lipoprotein (HDL): a f
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Very-low-calorie diet (VLCD): a die
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Additional Internet searches were c
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This report addresses obesity in ad
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Many systemic factors have been ide
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Severe obesity is associated with d
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eport their height and under-report
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Also using self-reported data from
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An examination of overall obesity d
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Table S.2 presents the associationa
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• have multiple focal points and
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The main problem in any weight mana
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food, and a negative body image. As
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directly causes death. 61 To the ex
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The addition of a selected pharmaco
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lack of formal training in nutritio
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slightly more likely to have prescr
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selection criteria, have facilities
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Barriers to using appropriate baria
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Overview of adult obesityOver the p
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the need for regular physical activ
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phenylpropanolamine/25. Sibutramine
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Complianceand AdherenceDemand andut
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Aetna Clinical PolicyBulletinswww.a
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Overweight 123,821 172,971 157,623
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REFERENCES1. 2006 Canadian clinical
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34. Gostin LO. Fast and supersized:
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69. Klarenbach S, Padwal R, Wiebe N
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105. Hill JO, Thompson H, Wyatt H.
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141. Ross R, Bradshaw AJ. The futur
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172. Arkinson J, Ji H, Fallah S, Pe
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This section will address a set of
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dietary therapy is to reduce total
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Additional benefits of exercise ove
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medications that inhibit intestinal
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Rimonabant may be considered for pa
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Long-term complications are specifi
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Devices used for bariatric surgeryH
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Description of the Included Systema
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AEs for sibutramineAs compared to a
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Evidence on Efficacy/EffectivenessW
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Table T.7: Effects of behavioural t
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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
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The investigators pointed out that
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approximately 3 to 5 kilograms. For
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for studies with a mean age of part
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Examining whether use of any of the
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Evidence from placebo-controlled cl
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colorectal or gastroesophageal or f
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Web of ScienceISI Interface License
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AMA Clinical PracticeGuidelineswww.
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critical appraisal of the included
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APPENDIX T.B: EXCLUDED STUDIESTable
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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
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Partially reported: The study types
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Table T.C.1: Results of quality ass
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Table T.C.1: Results of quality ass
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APPENDIX T.D: CHARACTERISTICS OF SY
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Table T.D.1: Characteristics of the
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APPENDIX T.E: EVIDENCE TABLE ON SAF
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Serious surgical complicationsSurgi
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LSGmMAMDNAnssORQoLRCTRDRRRYGBSBPTGV
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Table T.F.1-2: Weight loss - Behavi
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Table T.F.1-4: Weight loss - Surger
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Table T.F.2: Quality of life (QoL)
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Curioni & Lourenco 2005 58Cholester
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Table T.F.3-3: Risk factors/comorbi
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Table T.F.3-5: Long-term effects of
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Maciejewski et al., 2005 65Avenell
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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
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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
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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 224 and 225: S4Economic burden of obesityMean co
Page 226 and 227: 15. Lacey LA, Wolf A, O'shea D, Ern
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Bariatric treatments for adult obesity - Institute of Health Economics

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