학술논문
Obesity in adults: Clinical practice guideline adapted for Chile.
Document Type
Academic Journal
Author
Preiss Contreras Y; Centro de Nutrición y Cirugía Bariátrica, Clínica Las Condes, Chile.; Ramos Salas X; Obesity Canada, Edmonton, Canadá.; Ávila Oliver C; Fundación Epistemonikos, Providencia, Santiago, Chile.; Saquimux Contreras MA; Obesity Canada, Edmonton, Canadá.; Muñoz Claro R; Centro de Nutrición y Cirugía Bariátrica, Clínica Las Condes, Chile.; Canales Ferrada C; Cátedra de Cirugía, Universidad de Valparaíso, Valparaíso, Chile.
Source
Publisher: Medwave Estudios Limitada Country of Publication: Chile NLM ID: 101581949 Publication Model: Electronic Cited Medium: Internet ISSN: 0717-6384 (Electronic) Linking ISSN: 07176384 NLM ISO Abbreviation: Medwave Subsets: MEDLINE
Subject
Language
English; Spanish; Castilian
Abstract
Introduction: The Chilean Society of Bariatric and Metabolic Surgery, together with other scientific societies, led a process for adapting the Canadian clinical practice guideline for obesity in adults for Chile. The aim of the Canadian guideline, among its main objectives, was to propose changes in obesity management using a chronic disease framework and focusing on improving patient-centered health outcomes, rather than focusing on weight loss alone.
Methods: A group of 58 healthcare professionals applied the GRADE-Adolopment method to analyze and adapt the original recommendations and to create de novo recommendations. New recommendations were developed through a systematic review of the evidence using the Epistemonikos database and based on the GRADE-Evidence to Decision (EtD) framework.
Results: Seventy-six (76) of the 80 original recommendations were adopted, one recommendation was adapted, and 12 new recommendations were created.
Conclusions: The adaptation process reduced the time needed to develop a Chilean clinical practice guideline for the management of obesity in adults. The change in obesity management approaches towards non-stigmatizing and patient-centered strategies focused on improving health outcomes and not solely on weight reduction is universal and it is possible to apply this approach in different countries and contexts.
Competing Interests: Verónica Álvarez has received speaker's fees from Novo Nordisk and Saval; she has received funding for attendance at Novo Nordisk congresses or events. Paulina Andrade Risso has received honoraria as a speaker from RedSalud and Teva; has received funding for attendance at congresses or events from Novo Nordisk; is a member of the Chilean Society of Bariatric and Metabolic Surgery. Camila Avila has received honoraria from the Chilean Society of Bariatric and Metabolic Surgery for the methodological development of the Canadian Practice Guide's adaptation process, attending congresses or events, and participating as a lecturer. Claudio Canales is the director of the Chilean Society of Bariatric and Metabolic Surgery. Carolina Carrasco has received funding to attend congresses or events from Novo Nordisk. Fernando Carrasco has received grants from FONDECYT; has received honoraria as a speaker from Novo Nordisk; has received funding to attend congresses or events from Novo Nordisk; has been an executive member of the Chilean Association of Clinical Nutrition, Obesity and Metabolism and an advisory member of the European Society for Clinical Nutrition and Metabolism. Ariel Cisternas Villalobos is a member of the Chilean Society of Sleep Medicine. Ada Cuevas has received speaker's fees from Axon Pharma, Abbott, NovoNordisk, Pasteur, Saval, Tecnofarma, and Teva; received funding to attend congresses or events from Pasteur; was a member of advisory boards for Axon Pharma and Tecnofarma. Samuel Durán Agüero has received funding for attendance to congresses or events from ILSI Norandino; he is a member of the board of directors of the Chilean Nutrition Society. Elizabeth Erdös Gattoni has received funding for attendance at congresses or events from Grunenthal. Alex Escalona has received honoraria as a consultant from Allurion Inc. and as a speaker from Allurion Inc. and Fulbright Inc. and received funding for attendance at congresses or events from Cegasurgical. Magdalena Farías has received honoraria as a speaker from Novo Nordisk. Daniela Eugenia Gómez Pérez has received scholarships from Novo Nordisk. María Isabel González Galvez has received honoraria as a speaker from Boeringer Ingelheim Chile; she has received funding for attendance to congresses or events from Boeringer Ingelheim Chile. Carolina González Reyes is director of the Chilean Society of Family Medicine. Patricio Lamoza Kohan is a member of the Chilean Society of Bariatric and Metabolic Surgery. María José Leiva Velasco has received speaker's fees from Novo Nordisk. Marcia López Aceitón has received medical samples for treatment from NovoNordisk. Denisse Montt Saavedra has received speaker fees from Novo Nordisk. Manuel Moreno is a member and director of the Chilean Society of Clinical Nutrition and Metabolism. Rodrigo Muñoz Claro is the director of the Chilean Society of Bariatric and Metabolic Surgery. Karin Papapietro has received honoraria as a speaker from Novo Nordisk. Israel Podestá Donoso is head of the Chilean Society of Metabolic Kinesiology research committee. Yudith Preiss Contreras has received an honorarium as a speaker from Novo Nordisk. Part of the OC-EASO grant was used to cover Yudith Preiss' clinical time to act as project coordinator. Ximena Ramos Salas has received consulting fees from Obesity Canada, the European Association for the Study of Obesity, and the World Health Organization; received a research grant from the Canadian Institutes of Health Research; received speaker's fees for events and courses from the World Health Organization - Europe, Obesity Canada, European Association for the Study of Obesity, Novo Nordisk, Obesity Society, Novo Nordisk Chile, the Instituto Mexicano en Salud; has been or is part of the oversight board or advisory board of SOPHIA data security, has been or is the leader of the Advocacy and Policy Committee of Obesity Society, the political action team of Obesity Canada, and the working group on the stigma of the World Obesity Federation. Camila Rodriguez has received medical samples for treatment from Novo Nordisk. Miguel Alejandro Saquimux Contreras has received honoraria as a consultant from Obesity Canada and has received funding from the European Association for the Study of Obesity for attendance at congresses or events. Matías Sepúlveda has received honoraria as a speaker at events and courses from Johnson & Johnson; he is vice-president of the Chilean Society of Bariatric and Metabolic Surgery. Arturo Zumaeta Valenzuela has received honoraria as a speaker from Novo Nordisk; received funding for attendance at congresses or events from Lundbeck; has received medical samples from Abbott, Eurofarma, GSK, ITF Labomed, Lundbeck, Pfizer, Saval, Royal Pharma, and Teva. Ornella Allegro González, Enzo Gonzalo Arias Isla, Viviana Assadi Altamirano, Camilo Boza, Percy Brante Báez, Susana Ivonne Cortes Mellado, Attila Csendes Juhasz, Cristóbal Davanzo Castillo, María José Figueroa Sgro, José Galgani, Carla Guzmán Pincheira, Oscar Henriquez Toledo, Andrea Herrera Santelices, Enrique Lanzarini Sobrevia, Patricia León Riquelme, Fernando Maluenda Gatica, Deborah Navarro-Rosenblatt, Camila Oda Montecinos, Pablo Olguín Veloso, Solange Parra-Soto, Johanna Pino Zuñiga, Ximena Prat, Lorena Rodríguez-Osiac, Karen Salvo Cofman, José Luis Santos, Erika Jeannette Troncoso Ortiz, Fernanda Valdés Pérez, Gabriela Vargas Martínez, and Gonzalo Wiedmaier Teare report no conflicts of interest.
(This work is licensed under a Creative Commons Attribution 4.0 International License.)
Methods: A group of 58 healthcare professionals applied the GRADE-Adolopment method to analyze and adapt the original recommendations and to create de novo recommendations. New recommendations were developed through a systematic review of the evidence using the Epistemonikos database and based on the GRADE-Evidence to Decision (EtD) framework.
Results: Seventy-six (76) of the 80 original recommendations were adopted, one recommendation was adapted, and 12 new recommendations were created.
Conclusions: The adaptation process reduced the time needed to develop a Chilean clinical practice guideline for the management of obesity in adults. The change in obesity management approaches towards non-stigmatizing and patient-centered strategies focused on improving health outcomes and not solely on weight reduction is universal and it is possible to apply this approach in different countries and contexts.
Competing Interests: Verónica Álvarez has received speaker's fees from Novo Nordisk and Saval; she has received funding for attendance at Novo Nordisk congresses or events. Paulina Andrade Risso has received honoraria as a speaker from RedSalud and Teva; has received funding for attendance at congresses or events from Novo Nordisk; is a member of the Chilean Society of Bariatric and Metabolic Surgery. Camila Avila has received honoraria from the Chilean Society of Bariatric and Metabolic Surgery for the methodological development of the Canadian Practice Guide's adaptation process, attending congresses or events, and participating as a lecturer. Claudio Canales is the director of the Chilean Society of Bariatric and Metabolic Surgery. Carolina Carrasco has received funding to attend congresses or events from Novo Nordisk. Fernando Carrasco has received grants from FONDECYT; has received honoraria as a speaker from Novo Nordisk; has received funding to attend congresses or events from Novo Nordisk; has been an executive member of the Chilean Association of Clinical Nutrition, Obesity and Metabolism and an advisory member of the European Society for Clinical Nutrition and Metabolism. Ariel Cisternas Villalobos is a member of the Chilean Society of Sleep Medicine. Ada Cuevas has received speaker's fees from Axon Pharma, Abbott, NovoNordisk, Pasteur, Saval, Tecnofarma, and Teva; received funding to attend congresses or events from Pasteur; was a member of advisory boards for Axon Pharma and Tecnofarma. Samuel Durán Agüero has received funding for attendance to congresses or events from ILSI Norandino; he is a member of the board of directors of the Chilean Nutrition Society. Elizabeth Erdös Gattoni has received funding for attendance at congresses or events from Grunenthal. Alex Escalona has received honoraria as a consultant from Allurion Inc. and as a speaker from Allurion Inc. and Fulbright Inc. and received funding for attendance at congresses or events from Cegasurgical. Magdalena Farías has received honoraria as a speaker from Novo Nordisk. Daniela Eugenia Gómez Pérez has received scholarships from Novo Nordisk. María Isabel González Galvez has received honoraria as a speaker from Boeringer Ingelheim Chile; she has received funding for attendance to congresses or events from Boeringer Ingelheim Chile. Carolina González Reyes is director of the Chilean Society of Family Medicine. Patricio Lamoza Kohan is a member of the Chilean Society of Bariatric and Metabolic Surgery. María José Leiva Velasco has received speaker's fees from Novo Nordisk. Marcia López Aceitón has received medical samples for treatment from NovoNordisk. Denisse Montt Saavedra has received speaker fees from Novo Nordisk. Manuel Moreno is a member and director of the Chilean Society of Clinical Nutrition and Metabolism. Rodrigo Muñoz Claro is the director of the Chilean Society of Bariatric and Metabolic Surgery. Karin Papapietro has received honoraria as a speaker from Novo Nordisk. Israel Podestá Donoso is head of the Chilean Society of Metabolic Kinesiology research committee. Yudith Preiss Contreras has received an honorarium as a speaker from Novo Nordisk. Part of the OC-EASO grant was used to cover Yudith Preiss' clinical time to act as project coordinator. Ximena Ramos Salas has received consulting fees from Obesity Canada, the European Association for the Study of Obesity, and the World Health Organization; received a research grant from the Canadian Institutes of Health Research; received speaker's fees for events and courses from the World Health Organization - Europe, Obesity Canada, European Association for the Study of Obesity, Novo Nordisk, Obesity Society, Novo Nordisk Chile, the Instituto Mexicano en Salud; has been or is part of the oversight board or advisory board of SOPHIA data security, has been or is the leader of the Advocacy and Policy Committee of Obesity Society, the political action team of Obesity Canada, and the working group on the stigma of the World Obesity Federation. Camila Rodriguez has received medical samples for treatment from Novo Nordisk. Miguel Alejandro Saquimux Contreras has received honoraria as a consultant from Obesity Canada and has received funding from the European Association for the Study of Obesity for attendance at congresses or events. Matías Sepúlveda has received honoraria as a speaker at events and courses from Johnson & Johnson; he is vice-president of the Chilean Society of Bariatric and Metabolic Surgery. Arturo Zumaeta Valenzuela has received honoraria as a speaker from Novo Nordisk; received funding for attendance at congresses or events from Lundbeck; has received medical samples from Abbott, Eurofarma, GSK, ITF Labomed, Lundbeck, Pfizer, Saval, Royal Pharma, and Teva. Ornella Allegro González, Enzo Gonzalo Arias Isla, Viviana Assadi Altamirano, Camilo Boza, Percy Brante Báez, Susana Ivonne Cortes Mellado, Attila Csendes Juhasz, Cristóbal Davanzo Castillo, María José Figueroa Sgro, José Galgani, Carla Guzmán Pincheira, Oscar Henriquez Toledo, Andrea Herrera Santelices, Enrique Lanzarini Sobrevia, Patricia León Riquelme, Fernando Maluenda Gatica, Deborah Navarro-Rosenblatt, Camila Oda Montecinos, Pablo Olguín Veloso, Solange Parra-Soto, Johanna Pino Zuñiga, Ximena Prat, Lorena Rodríguez-Osiac, Karen Salvo Cofman, José Luis Santos, Erika Jeannette Troncoso Ortiz, Fernanda Valdés Pérez, Gabriela Vargas Martínez, and Gonzalo Wiedmaier Teare report no conflicts of interest.
(This work is licensed under a Creative Commons Attribution 4.0 International License.)