A new guideline ‘Overweight and obesity in adults’ is available. This guideline contains the care-related aspects. The roles of the various care providers are described in a care standard. The KNMP was part of the guideline working group for this multidisciplinary guideline.
Pharmacotherapy in the guideline
Below are the main recommendations on pharmacotherapy for overweight and obesity in adults:
Weight-reducing medication can be considered in people with obesity or severe overweight in combination with an increased abdominal circumference and/or comorbidities, in combination with a Combined Lifestyle Intervention (GLI). Liraglutide, semaglutide and naltrexone/bupropion are more effective than orlistat. Naltrexone/bupropion is not recommended if there is a risk of convulsions and psychiatric or addiction problems. Orlistat, liraglutide and naltrexone/bupropion should be discontinued if weight loss is less than 5% after 12 weeks of maximum tolerated dose. If less than 5% weight loss has been achieved, but clear improvements have occurred in body composition and (for example, cardiometabolic) comorbidities, it may be considered to extend the trial period with medication for several months.
With the arrival of this guideline, the Scientific Section of Community Pharmacists (WSO) sees opportunities for pharmacists in regional cooperation. For example, pharmacists can use the guideline to discuss the following matters with other healthcare providers, for example in an FTO:
The pharmacist performs medication monitoring in patients with morbid obesity and patients who have undergone bariatric surgery, because both patient groups may have altered pharmacokinetics and drug dynamics. It is necessary for good medication guidance and associated pharmaceutical care to have the contraindication Morbid obesity or bariatric surgery recorded in the system and exchanged in the care chain. It is helpful if the pharmacist has a medication review to see if medication needs to be adjusted, for example contraception or a DOAC. As a medicine specialist, the pharmacist contributes ideas when choosing weight-reducing medication. Prevention: The pharmacist does a medication review – or evaluation for potential weight-increasing medication and/or movement-impairing factors.
Support from the KNMP
The KNMP provides support in the care of obese patients and patients who have undergone bariatric surgery. The Morbid Obesity and Bariatric Surgery dossier on KNMP.nl contains a knowledge document, various practical examples, articles and public materials.
View the file
2023-07-10 15:43:44
#guideline #Overweight #obesity #adults
