Gibbs, Helen, Broom, John, Brown, Jenny, Laws, Rachel, Reckless, John, Noble, Paula, Kumar, Sudhesh, McCombie, Louise, Lean, Mike, Lyons, Felicity, Frost, Gary, Quinn, Marney, Barth, Julian H., Haynes, Sarah, Finer, Nick, Ross, Hazel, Hole, David and Bray, Caroline A. (2005) The impact of obesity on drug prescribing in primary care. British Journal of General Practice, Volume 55 (Number 519). pp. 743-749. ISSN 0960-1643

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Abstract

Background Healthcare costs attributable to obesity have previously involved estimations based on costs of diseases commonly considered as having obesity as an underlying factor.

Aim To quantify the impact of obesity on total primary care drug prescribing.

Design of study Review of computer generated and handwritten prescriptions to determine total prescribing volume for all drug classes.

Setting Twenty-three general practice surgeries in the UK.

Method Stratified random selection of 1150 patients who were obese (body mass index [BMI]> 30 kg/m(2)) and 1150 age-and sex-matched controls of normal weight (BMI 18.5-< 25 kg/m(2)). Retrospective review of medical records over an 18-month period.

Results A higher percentage of patients who were obese, compared with those of normal weight, were prescribed at least one drug in the following disease categories: cardiovascular (36% versus 20%), central nervous system (46% versus 35%), endocrine (26% versus 18%), and musculoskeletal and joint disease (30% versus 22%). All of these categories had a P-value of < 0.001. Other categories, such as gastrointestinal (24% versus 18%), infections (42% versus 35%), skin (24% versus 19%) had a P-value of < 0.01, while respiratory diseases (18% versus 21%) had a P-value of < 0.05. Total prescribing volume was significantly higher for the group with obesity and was increased in the region of two- to fourfold in a wide range of prescribing categories: ulcer healing drugs, lipid regulators, P-adrenoreceptor drugs, drugs affecting the rennin angiotensin system, calcium channel blockers, antibacterial drugs, sulphonylureas, biguanides, non-steroidal anti-inflammatories (NSAIDs) (P < 0.001) and fibrates, angiotensin II antagonists, and thyroid drugs (P < 0.05). The main impact on prescribing volumes is from numbers of patients treated, although in some areas there is an effect from greater dosage or longer treatment in those who are obese including calcium channel blockers, antihistamines, hypnotics, drugs used in the treatment of nausea and vertigo, biguanicles, and NSAIDs (P < 0.05) reflected in significantly increased defined daily dose prescribing.

Conclusions This large study of contemporary practice indicates that obesity more than doubled prescribing in most drug categories.

Item Type:	Journal Article
Subjects:	R Medicine
Divisions:	Faculty of Medicine > Warwick Medical School > Translational & Systems Medicine > Metabolic and Vascular Health Faculty of Medicine > Warwick Medical School
Journal or Publication Title:	British Journal of General Practice
Publisher:	Royal College of General Practitioners
ISSN:	0960-1643
Official Date:	October 2005
Volume:	Volume 55
Number:	Number 519
Number of Pages:	7
Page Range:	pp. 743-749
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
URI:	http://wrap.warwick.ac.uk/id/eprint/34346

Data sourced from Thomson Reuters' Web of Knowledge

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