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J Gen Intern Med. 2017 Apr;32(Suppl 1):70-73. doi: 10.1007/s11606-016-3949-y.

Pharmacotherapy for Weight Management in the VHA.

Author information

1
Pharmacy Benefits Management Services, Department of Veterans Affairs, 1st Ave. - 1 Block N. of Cermak Rd, Building 37 (10P4P), Hines, IL, 60141, USA. Todd.semla@va.gov.
2
Department of Medicine, and Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. Todd.semla@va.gov.
3
VA Connecticut Healthcare System, New Haven, CT, USA.
4
Yale University School of Medicine, New Haven, CT, USA.
5
Pharmacy Benefits Management Services, Department of Veterans Affairs, 1st Ave. - 1 Block N. of Cermak Rd, Building 37 (10P4P), Hines, IL, 60141, USA.
6
Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
7
Division of General Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
8
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA.
9
David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
10
West Los Angeles VA Medical Center, Los Angeles, CA, USA.
11
VA Central Western Massachusetts, Leeds, MA, USA.
12
Minneapolis VA Medical Center, Minneapolis, MN, USA.
13
VA Southern Nevada Health Care System, Las Vegas, NV, USA.
14
Comprehensive Weight Control Program, Weill-Cornell Medicine, New York, NY, USA.
15
Center for Weight and Eating Disorders, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
16
Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA.
17
Geriatric Research, Education and Clinical Center, Birmingham VA Medical Center, Birmingham, AL, USA.
18
Boston University School of Medicine, Nutrition and Weight Management and Nutrition and Support Service at Boston Medical Center, Boston, MA, USA.
19
Health Service Research and Development, US Department of Veterans Affairs, Washington, DC, USA.

Abstract

Weight management medications (WMM) are underutilized as an adjunct to behavioral and lifestyle interventions. In fiscal years 2014-2015, a total of approximately 2500 veterans-a mere 2% of veterans receiving care from the Veterans Health Administration (VHA)-eligible for a WMM received a prescription for one. A State of the Art Conference on Weight Management workgroup, focused on pharmacotherapy, developed evidence-based recommendations and strategies to foster the appropriate use of WMM in the VHA. The workgroup identified patient, prescriber, and health system barriers to and facilitators for prescribing WMM. Barriers included patient and provider concerns about medication safety and efficacy, limited involvement of primary care, restrictive medication criteria for use (CFU), and skepticism among providers regarding the safety and efficacy of WMM and the perception of obesity as a disease. Potential facilitators for removing barriers included patient and provider education about WMM and the health benefits of weight loss, increased engagement of primary care providers in weight management, relaxation of the CFU, and creation of a system to help patients navigate through weight management treatment options. Several research questions were framed with regard to WMM in general, and specifically to the care of obese veterans. While some of the workgroup's conclusions reflect issues specific to the VHA, many are likely to be applicable to other health organizations.

KEYWORDS:

obesity; pharmaceutical care; veterans

PMID:
28271432
PMCID:
PMC5359152
DOI:
10.1007/s11606-016-3949-y
[Indexed for MEDLINE]
Free PMC Article

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