The burden of obesity in primary care in Italy: Italian real-world overweight/obesity study (ITROS)

Abstract

Purpose: Generating real-world evidence on individuals living with severe overweight or obesity in Italy, focusing on their characterization and management from general practitioners (GPs) perspective. Methods: This was a non-interventional longitudinal observational cohort study using data from the Italian IQVIA Longitudinal Patient Database (LPD), conducted in collaboration with a working group from the 'Società Italiana di Obesità'. The study included individuals with body mass index (BMI) ≥ 27 kg/m2 during 'January 2018-June 2022'. Data on clinical conditions, GP interventions (including drug prescriptions, and referrals for laboratory tests, instrumental examinations, and specialist visits), and hospitalizations were collected during the year preceding (baseline) and following BMI recording. Data were analyzed according to time (follow-up versus baseline) and BMI thresholds. Results: The final cohort consisted of 134,776 individuals: 44.9% with severe overweight, 36.7% with class I, 12.9% with class II, and 5.6% with class III obesity. Overall mean age was 59.9 years and men accounted for 52.9%. Mean age and male proportions decreased across increasing BMI categories. Most frequently recorded conditions during follow-up were hypertension (51.4%), cardiovascular disease (27.5%), and type-2 diabetes (25.1%). Proportions of subjects presenting with clinical conditions and of individuals requiring clinical interventions were higher during follow-up compared to baseline. The likelihood of presenting with most of clinical conditions and interventions increased with BMI. Conclusion: Patients living with overweight or obesity experience a significant worsening of their health status which increases healthcare resources utilization. Public health interventions could benefit from supporting GPs with training and resources to enhance obesity management and improve patient outcomes. Level of evidence: Level III: Evidence obtained from well-designed cohort or case-control analytic studies.