Bariatric treatments for adult obesity - Institute of Health Economics

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REFERENCES1. 2006 Canadian clinical practice guidelines on the management and prevention of obesity inadults and children. CMAJ 2007;176(8 Suppl):1-117.2. Scottish Intercollegiate Guidelines Network (SIGN). Management of obesity. A national clinicalguideline. Edinburgh, UK: 2010.3. Lau DC, Douketis JD, Morrison KM, Hramiak IM, Sharma AM, Ur E, et al. 2006 Canadianclinical practice guidelines on the management and prevention of obesity in adults andchildren [summary]. CMAJ 2007;176(8):S1-13.4. Newell B, Proust K, Dyball R, McManus P. Seeing obesity as a systems problem. Availableat: www.publish.csiro 2007 (accessed 2 March 2010).5. Sharma AM, Kushner RF. A proposed clinical staging system for obesity. International Journalof Obesity 2009;33:289-95.6. Tsigos C, Hainer V, Basdevant A, Finer N, Fried M, Mathus-Vliegen E, et al. Managementof obesity in adults: European clinical practice guidelines. Obesity Facts 2008;1:106-16.7. Snow V, Barry P, Fitterman N, Aaseem A, Weiss K. Pharmacologic and surgicalmanagement of obesity in primary care: a clinical practice guideline from the AmericanCollege of Physicians. Annals of Internal Medicine 2005;142(7):525-31.8. Baillargeon JP, Carpentier A, Donovan D, Fortin M, Grant A, Simoneau-Roy J, et al.Integrated obesity care management system–implementation and research protocol. BMCHealth Services Research 2007;7:163.9. Shields M, Tjepkema M. Regional differences in obesity. Health Reports 2006;17(3):61-7.10. Shields M, Tjepkema M. Trends in adult obesity. Health Reports 2006;17(3):53-9.11. Le Petit C, Berthelot JM. Obesity—a growing issue. Health Reports 2006;17(3):43-50.12. Tjepkema M. Adult obesity. Health Reports 2006;17(3):9-25.13. National Collaborating Centre for Primary Care and the Centre for Public Health Excellenceat NICE. Obesity: guidance on the prevention, identification, assessment and management of overweight andobesity in adults and children. London, UK: National Institute for Health and Clinical Excellence(NICE), 2006.14. Flum DR, Khan TV, Dellinger EP. Toward the rational and equitable use of bariatric surgery.JAMA 2007;298(12):1442-4.15. Lim RB, Blackburn GL, Jones DB. Benchmarking best practices in weight loss surgery.Current Problems in Surgery 2010;47(2):79-174.16. Hayward K, Colman R. Cost of obesity in Alberta. Part I. Edmonton, AB: Alberta Cancer Board,2009.Bariatric treatments for adult obesity 50
17. Hassen-Khodja R, Lance JR. Surgical treatment of morbid obesity. An update. Montreal, QC:Agence d'evaluation des technologies et des modes d'intervention en sante (AETMIS); 2006.Report No.: August 2006.18. Logue J, Thompson L, Romanes F, Wilson DC, Thompson J, Sattar N. Management ofobesity: summary of SIGN guideline. BMJ 2010;340(c154):474-7.19. Understanding adult obesity. Available at:http://win.middk.nih.gov/publications/understanding.htm 2008 (accessed 23 February 2010).20. National Guideline Clearinghouse. Prevention and management of obesity (matureadolescents and adults). Available at: www.guideline.gov/summary 2009 (accessed 6 April 2010).21. National Institutes of Health. The practical guide identification, evaluation, and treatment of overweightand obesity in adults. California, United States: National Institute of Health (NIH), 2000.22. Douketis JD, Paradis G, Keller H, Martineau C. Canadian guidelines for body weightclassification in adults: application in clinical practice to screen for overweight and obesityand to assess disease risk. CMAJ 2005;172(8):995-8.23. Gurevich-Panigrahi T, Panigrahi S, Wiechec E, Los M. Obesity: pathophysiology and clinicalmanagement. Current Medicinal Chemistry 2009;16(4):506-21.24. Kaila B, Raman M. Obesity: a review of pathogenesis and management strategies. CanadianJournal of Gastroenterology 2008;22(1):61-8.25. Dixon JB. The effect of obesity on health outcomes. Molecular & Cellular Endocrinology2010;316(2):104-8.26. Iacobellis G, Sharma AM. Obesity and the heart: redefinition of the relationship. ObesityReviews 2007;8(1):35-9.27. Reddy S. Care pathway for the management of overweight and obesity. London, UK: DH Publications,2006.28. Health Surveillance Alberta Health and Wellness. Self-reported body mass index and its correlates inAlberta: a portrait from survey and administrative data sources. Edmonton, AB: Alberta Health andWellness, 2005.29. Tjepkema M. Measured obesity. Adult obesity in Canada: measured height and weight. Ottawa, ON:Statistics Canada, 2005.30. Samaha FF. New international measuring stick for defining obesity in non-Europeans.Circulation 2007;115(16):2089-90.31. Raine KD. Overweight and obesity in Canada. A population health perspective. Ottawa, ON:Canadian Institute for Health Information (CIHI), 2004.32. Starky S. The obesity epidemic in Canada. Ottawa, ON: Library of Parliament; 2005. Report No.:PRB 05-11E.33. Shields M, Tremblay MS, Laviolette M, Craig CL, Janssen K, Gorber SC. Fitness ofCanadian adults: results from the 2007-2009 Canadian Health Measures Survey. Available at:www.statcan.gc.ca/pub/82-003-x/2010001/article/11064-eng.htm 2010 (accessed 23 February2010).Bariatric treatments for adult obesity 51
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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
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 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
Page 110 and 111: follow-up time was 3 years. Results
Page 112 and 113: group as compared to the VBG group.
Page 114 and 115: The authors identified many methodo
Page 116 and 117: The investigators pointed out that
Page 118 and 119: 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
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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
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Table T.G.4: Effects of bariatric s
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18. Cerulli J, Lomaestro BM, Malone
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50. Health Canada Drug Product Data
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SECTION THREE: ECONOMIC EVALUATIONC
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Definition of bariatric surgical pa
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etween surgical interventions, the
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concluded that adding orlistat to L
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Weight management program (WMP) ver
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groups. Compared with standard care
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Results from Analysis of Provincial
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DiscussionThe objectives of the eco
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surgical suites, and so on. The bud
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APPENDIX E.A: LITERATURE SEARCH SUM
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CRD Databases(DARE, HTA & NHS EED)h
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Web of ScienceISI Interface License
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NEOS Librarywww.library.ualberta.ca
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Table E.A.2: Evidence table of revi
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ResultHealth outcomesCostsMarginal
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CostsMarginal analysisThe cost anal
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Time Horizon/discount rateCurrency/
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Objectivestudy perspective: society
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S4Economic burden of obesityMean co
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15. Lacey LA, Wolf A, O'shea D, Ern
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Author Contribution StatementsPaula
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