Multimorbidity and weight loss in obese primary care patients: longitudinal study based on electronic healthcare records
Objective To analyse the association between cardiovascular and mental comorbidities of obesity and weight loss registered in the electronic primary healthcare records. Design and setting Longitudinal study of a cohort of adult patients assigned to any of the public primary care centres in Aragon, S...
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| Veröffentlicht in: | BMJ open 2015-03, Vol.5 (3), p.e006227-e006227 |
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| creator | Calderón-Larrañaga, Amaia Hernández-Olivan, Paola González-Rubio, Francisca Gimeno-Feliu, Luis A Poblador-Plou, Beatriz Prados-Torres, Alexandra |
| description | Objective To analyse the association between cardiovascular and mental comorbidities of obesity and weight loss registered in the electronic primary healthcare records. Design and setting Longitudinal study of a cohort of adult patients assigned to any of the public primary care centres in Aragon, Spain, during 2010 and 2011. Participants Adult obese patients for whom data on their weight were available for 2010 (n=62 901), and for both 2010 and 2011 (n=42 428). Outcomes Weight loss (yes/no) was calculated based on the weight difference between the first value registered in 2010 and the last value registered in 2011. Multivariate logistic regression models were adjusted for individuals’ age, sex, total number of chronic comorbidities, type of obesity and length of time between both weight measurements. Results According to the recorded clinical information, 9 of 10 obese patients showed at least one chronic comorbidity. After adjusting for covariates, weight loss seemed to be more likely among obese patients with a diagnosis of diabetes and/or dementia and less likely among those with hypertension, anxiety and/or substance use problems (p |
| doi_str_mv | 10.1136/bmjopen-2014-006227 |
| format | Article |
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Design and setting Longitudinal study of a cohort of adult patients assigned to any of the public primary care centres in Aragon, Spain, during 2010 and 2011. Participants Adult obese patients for whom data on their weight were available for 2010 (n=62 901), and for both 2010 and 2011 (n=42 428). Outcomes Weight loss (yes/no) was calculated based on the weight difference between the first value registered in 2010 and the last value registered in 2011. Multivariate logistic regression models were adjusted for individuals’ age, sex, total number of chronic comorbidities, type of obesity and length of time between both weight measurements. Results According to the recorded clinical information, 9 of 10 obese patients showed at least one chronic comorbidity. After adjusting for covariates, weight loss seemed to be more likely among obese patients with a diagnosis of diabetes and/or dementia and less likely among those with hypertension, anxiety and/or substance use problems (p<0.05). The probability of weight loss was also significantly higher in male patients with more severe obesity and older age. Conclusions An increased probability of weight loss over 1 year was observed in older obese male patients, especially among those already manifesting high levels of obesity and severe comorbidities such as diabetes and/or dementia. Yet patients with certain psychological problems showed lower rates of weight reduction. Future research should clarify if these differences persist beyond potential selective weight documentation in primary care, to better understand the trends in weight reduction among obese patients and the underlying role of general practitioners regarding such trends.</description><identifier>ISSN: 2044-6055</identifier><identifier>EISSN: 2044-6055</identifier><identifier>DOI: 10.1136/bmjopen-2014-006227</identifier><identifier>PMID: 25783419</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Adolescent ; Adult ; Age ; Aged ; Anxiety - complications ; Anxiety Disorders - complications ; Body mass index ; Chronic Disease ; Chronic illnesses ; Comorbidity ; Dementia - complications ; Diabetes Mellitus, Type 1 - complications ; Diabetes Mellitus, Type 2 - complications ; Female ; General practice / Family practice ; Health care ; Humans ; Hypertension - complications ; Logistic Models ; Longitudinal Studies ; Male ; Mental Disorders - complications ; Mental health ; Middle Aged ; Obesity ; Obesity - complications ; Obesity - psychology ; Obesity, Morbid - complications ; Obesity, Morbid - psychology ; Population ; Primary care ; Primary Health Care ; Spain ; Substance-Related Disorders - complications ; Trends ; Weight control ; Weight Loss ; Womens health ; Young Adult</subject><ispartof>BMJ open, 2015-03, Vol.5 (3), p.e006227-e006227</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions 2015 This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b472t-429452944aa3e8af4a4b52149b009dfb478a88261e908971277ff81fa7856a1e3</citedby><cites>FETCH-LOGICAL-b472t-429452944aa3e8af4a4b52149b009dfb478a88261e908971277ff81fa7856a1e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://bmjopen.bmj.com/content/5/3/e006227.full.pdf$$EPDF$$P50$$Gbmj$$Hfree_for_read</linktopdf><linktohtml>$$Uhttp://bmjopen.bmj.com/content/5/3/e006227.full$$EHTML$$P50$$Gbmj$$Hfree_for_read</linktohtml><link.rule.ids>230,314,725,778,782,862,883,27536,27537,27911,27912,53778,53780,77356,77387</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25783419$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Calderón-Larrañaga, Amaia</creatorcontrib><creatorcontrib>Hernández-Olivan, Paola</creatorcontrib><creatorcontrib>González-Rubio, Francisca</creatorcontrib><creatorcontrib>Gimeno-Feliu, Luis A</creatorcontrib><creatorcontrib>Poblador-Plou, Beatriz</creatorcontrib><creatorcontrib>Prados-Torres, Alexandra</creatorcontrib><title>Multimorbidity and weight loss in obese primary care patients: longitudinal study based on electronic healthcare records</title><title>BMJ open</title><addtitle>BMJ Open</addtitle><description>Objective To analyse the association between cardiovascular and mental comorbidities of obesity and weight loss registered in the electronic primary healthcare records. Design and setting Longitudinal study of a cohort of adult patients assigned to any of the public primary care centres in Aragon, Spain, during 2010 and 2011. Participants Adult obese patients for whom data on their weight were available for 2010 (n=62 901), and for both 2010 and 2011 (n=42 428). Outcomes Weight loss (yes/no) was calculated based on the weight difference between the first value registered in 2010 and the last value registered in 2011. Multivariate logistic regression models were adjusted for individuals’ age, sex, total number of chronic comorbidities, type of obesity and length of time between both weight measurements. Results According to the recorded clinical information, 9 of 10 obese patients showed at least one chronic comorbidity. After adjusting for covariates, weight loss seemed to be more likely among obese patients with a diagnosis of diabetes and/or dementia and less likely among those with hypertension, anxiety and/or substance use problems (p<0.05). The probability of weight loss was also significantly higher in male patients with more severe obesity and older age. Conclusions An increased probability of weight loss over 1 year was observed in older obese male patients, especially among those already manifesting high levels of obesity and severe comorbidities such as diabetes and/or dementia. Yet patients with certain psychological problems showed lower rates of weight reduction. Future research should clarify if these differences persist beyond potential selective weight documentation in primary care, to better understand the trends in weight reduction among obese patients and the underlying role of general practitioners regarding such trends.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age</subject><subject>Aged</subject><subject>Anxiety - complications</subject><subject>Anxiety Disorders - complications</subject><subject>Body mass index</subject><subject>Chronic Disease</subject><subject>Chronic illnesses</subject><subject>Comorbidity</subject><subject>Dementia - complications</subject><subject>Diabetes Mellitus, Type 1 - complications</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Female</subject><subject>General practice / Family practice</subject><subject>Health care</subject><subject>Humans</subject><subject>Hypertension - complications</subject><subject>Logistic Models</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Mental Disorders - complications</subject><subject>Mental health</subject><subject>Middle Aged</subject><subject>Obesity</subject><subject>Obesity - complications</subject><subject>Obesity - psychology</subject><subject>Obesity, Morbid - complications</subject><subject>Obesity, Morbid - psychology</subject><subject>Population</subject><subject>Primary care</subject><subject>Primary Health Care</subject><subject>Spain</subject><subject>Substance-Related Disorders - complications</subject><subject>Trends</subject><subject>Weight control</subject><subject>Weight Loss</subject><subject>Womens health</subject><subject>Young Adult</subject><issn>2044-6055</issn><issn>2044-6055</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>9YT</sourceid><sourceid>ACMMV</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNkV9rFDEUxQex2NL2EwgS8MWXqfmfjA-CFFuFSl_qc8jM3NnNkknWJFPdb2_aXUv1yUDIDfmdw705TfOa4AtCmHzfz5u4hdBSTHiLsaRUvWhOKOa8lViIl8_q4-Y85w2ui4tOCPqqOaZCacZJd9L8-rb44uaYeje6skM2jOgnuNW6IB9zRi6g2EMGtE1utmmHBpvqxRYHoeQPFQorV5bRBetRrsUO9TbDiGJA4GEoKQY3oDVYX9aP2gRDTGM-a44m6zOcH87T5vvV57vLL-3N7fXXy083bc8VLS2nHRd1c2sZaDtxy3tBCe96jLtxqpC2WlNJoMO6U4QqNU2aTFZpIS0Bdtp83Ptul36GcahtJ-vNYRwTrTN_vwS3Nqt4bziTutOsGrw7GKT4Y4FczOzyAN7bAHHJhkjJlRJMy4q-_QfdxCXVn6lU7YcxKh8ptqeGVH84wfTUDMHmIVxzCNc8hGv24VbVm-dzPGn-RFmBiz1Q1f_l-Bv_NLKa</recordid><startdate>20150317</startdate><enddate>20150317</enddate><creator>Calderón-Larrañaga, Amaia</creator><creator>Hernández-Olivan, Paola</creator><creator>González-Rubio, Francisca</creator><creator>Gimeno-Feliu, Luis A</creator><creator>Poblador-Plou, Beatriz</creator><creator>Prados-Torres, Alexandra</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>9YT</scope><scope>ACMMV</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20150317</creationdate><title>Multimorbidity and weight loss in obese primary care patients: longitudinal study based on electronic healthcare records</title><author>Calderón-Larrañaga, Amaia ; Hernández-Olivan, Paola ; González-Rubio, Francisca ; Gimeno-Feliu, Luis A ; Poblador-Plou, Beatriz ; Prados-Torres, Alexandra</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b472t-429452944aa3e8af4a4b52149b009dfb478a88261e908971277ff81fa7856a1e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age</topic><topic>Aged</topic><topic>Anxiety - complications</topic><topic>Anxiety Disorders - complications</topic><topic>Body mass index</topic><topic>Chronic Disease</topic><topic>Chronic illnesses</topic><topic>Comorbidity</topic><topic>Dementia - complications</topic><topic>Diabetes Mellitus, Type 1 - complications</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Female</topic><topic>General practice / Family practice</topic><topic>Health care</topic><topic>Humans</topic><topic>Hypertension - complications</topic><topic>Logistic Models</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Mental Disorders - complications</topic><topic>Mental health</topic><topic>Middle Aged</topic><topic>Obesity</topic><topic>Obesity - complications</topic><topic>Obesity - psychology</topic><topic>Obesity, Morbid - complications</topic><topic>Obesity, Morbid - psychology</topic><topic>Population</topic><topic>Primary care</topic><topic>Primary Health Care</topic><topic>Spain</topic><topic>Substance-Related Disorders - complications</topic><topic>Trends</topic><topic>Weight control</topic><topic>Weight Loss</topic><topic>Womens health</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Calderón-Larrañaga, Amaia</creatorcontrib><creatorcontrib>Hernández-Olivan, Paola</creatorcontrib><creatorcontrib>González-Rubio, Francisca</creatorcontrib><creatorcontrib>Gimeno-Feliu, Luis A</creatorcontrib><creatorcontrib>Poblador-Plou, Beatriz</creatorcontrib><creatorcontrib>Prados-Torres, Alexandra</creatorcontrib><collection>BMJ Open Access Journals</collection><collection>BMJ Journals:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ open</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Calderón-Larrañaga, Amaia</au><au>Hernández-Olivan, Paola</au><au>González-Rubio, Francisca</au><au>Gimeno-Feliu, Luis A</au><au>Poblador-Plou, Beatriz</au><au>Prados-Torres, Alexandra</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Multimorbidity and weight loss in obese primary care patients: longitudinal study based on electronic healthcare records</atitle><jtitle>BMJ open</jtitle><addtitle>BMJ Open</addtitle><date>2015-03-17</date><risdate>2015</risdate><volume>5</volume><issue>3</issue><spage>e006227</spage><epage>e006227</epage><pages>e006227-e006227</pages><issn>2044-6055</issn><eissn>2044-6055</eissn><abstract>Objective To analyse the association between cardiovascular and mental comorbidities of obesity and weight loss registered in the electronic primary healthcare records. Design and setting Longitudinal study of a cohort of adult patients assigned to any of the public primary care centres in Aragon, Spain, during 2010 and 2011. Participants Adult obese patients for whom data on their weight were available for 2010 (n=62 901), and for both 2010 and 2011 (n=42 428). Outcomes Weight loss (yes/no) was calculated based on the weight difference between the first value registered in 2010 and the last value registered in 2011. Multivariate logistic regression models were adjusted for individuals’ age, sex, total number of chronic comorbidities, type of obesity and length of time between both weight measurements. Results According to the recorded clinical information, 9 of 10 obese patients showed at least one chronic comorbidity. After adjusting for covariates, weight loss seemed to be more likely among obese patients with a diagnosis of diabetes and/or dementia and less likely among those with hypertension, anxiety and/or substance use problems (p<0.05). The probability of weight loss was also significantly higher in male patients with more severe obesity and older age. Conclusions An increased probability of weight loss over 1 year was observed in older obese male patients, especially among those already manifesting high levels of obesity and severe comorbidities such as diabetes and/or dementia. Yet patients with certain psychological problems showed lower rates of weight reduction. Future research should clarify if these differences persist beyond potential selective weight documentation in primary care, to better understand the trends in weight reduction among obese patients and the underlying role of general practitioners regarding such trends.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>25783419</pmid><doi>10.1136/bmjopen-2014-006227</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Age Aged Anxiety - complications Anxiety Disorders - complications Body mass index Chronic Disease Chronic illnesses Comorbidity Dementia - complications Diabetes Mellitus, Type 1 - complications Diabetes Mellitus, Type 2 - complications Female General practice / Family practice Health care Humans Hypertension - complications Logistic Models Longitudinal Studies Male Mental Disorders - complications Mental health Middle Aged Obesity Obesity - complications Obesity - psychology Obesity, Morbid - complications Obesity, Morbid - psychology Population Primary care Primary Health Care Spain Substance-Related Disorders - complications Trends Weight control Weight Loss Womens health Young Adult |
| title | Multimorbidity and weight loss in obese primary care patients: longitudinal study based on electronic healthcare records |
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