Comparison on the Pharmacokinetics and Weight Reduction of Clobenzorex Slow Release and Immediate Release Formulations in Obese Patients

Abstract Background: Addressing individuals’ motivation to lose weight among patients with morbid obesity is an essential entity in weight reduction. Failures to shift motivation into weight loss actions are common. These could be contributed by the inadequacy to identify and subsequently address the key reasons, that are of particular concern to the patient' individual needs. We aimed to understand the motivations better and identify the reasons why morbidly obese patients attending hospital-based weight management programmes (WMP) wanted to lose weight. Methods: The study used a qualitative approach to analyze part of a quantitative questionnaire of a more extensive study to understand factors influencing weight loss among morbidly obese patients. We used thematic content analysis to analyze responses from a self-administered open-ended question "What is the main factor why you want to lose your weight?”. A total of 225 new patients attending obesity clinics in two tertiary hospitals responded to the questionnaire. Results: Patients’ mean BMI was 45.6±8.05 kg/m2. Four themes emerged for the reasons why morbidly obese patients wanted to lose weight. Health was the most commonly inferred theme (84%). Patients were concerned about the impact obesity had on their health. Overcoming obesity was seen as a reward not just for physical health, but also for their psychological wellbeing. Patients regard being functional to care for themselves, their family members, as well as their religious and career needs as the next most crucial theme (25.8%). Patients raised the theme appearance (12.9%), especially with regards to wanting to look and feel beautiful. The last theme was perceived stigmatization for being morbidly obese as they were mocked and laughed at for their appearance (3.1%).Conclusion: Patients with morbid obesity in this study had expressed their main personal motivational reasons to lose weight. Concerns about the impact of morbid obesity on health, physical, social and obligatory function, appearance and perceived stigma warrant detailed exploration by the managing health professionals. Identifying and addressing these unique personal motivations in a focused approach is vital at the beginning and throughout a weight reduction program in this unique group.

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The Effect of Weight Reduction on Blood Pressure, Plasma Renin Activity, and Plasma Aldosterone Levels in Obese Patients

New England Journal of Medicine ◽

10.1056/nejm198104163041602 ◽

1981 ◽

Vol 304 (16) ◽

pp. 930-933 ◽

Cited By ~ 450

Author(s):

Michael L. Tuck ◽

James Sowers ◽

Leslie Dornfeld ◽

Gary Kledzik ◽

Morton Maxwell

Keyword(s):

Blood Pressure ◽

Plasma Renin Activity ◽

Weight Reduction ◽

Plasma Renin ◽

Plasma Aldosterone ◽

Renin Activity ◽

Obese Patients ◽

Pressure Plasma

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Effects of sibutramine on ventricular dimensions and heart valves in obese patients during weight reduction

American Heart Journal ◽

10.1067/mhj.2002.124403 ◽

2002 ◽

Vol 144 (3) ◽

pp. 508-515 ◽

Cited By ~ 49

Author(s):

Faiez Zannad ◽

Bertrand Gille ◽

Alain Grentzinger ◽

Jean-François Bruntz ◽

Mokrane Hammadi ◽

...

Keyword(s):

Weight Reduction ◽

Heart Valves ◽

Obese Patients ◽

Ventricular Dimensions

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Postoperative use of slow-release opioids: The impact of the Australian and New Zealand College of Anaesthetists/Faculty of Pain Medicine position statement on clinical practice

Anaesthesia and Intensive Care ◽

10.1177/0310057x20956664 ◽

2020 ◽

Vol 48 (6) ◽

pp. 444-453

Author(s):

Adeline CH Tan ◽

Bernadette A Bugeja ◽

David A Begley ◽

Jennifer A Stevens ◽

Kok-Eng Khor ◽

...

Keyword(s):

Clinical Practice ◽

New Zealand ◽

Odds Ratio ◽

Slow Release ◽

Immediate Release ◽

Prescribing Patterns ◽

Dose Titration ◽

Pain Medicine ◽

Zealand College ◽

The Impact

Dose titration with immediate-release opioids is currently recommended for acute pain. The Australian and New Zealand College of Anaesthetists and the Faculty of Pain Medicine released a statement in March 2018 supporting their use in the treatment of opioid-naïve patients; however, the impact of this statement on clinical practice is currently unknown. This retrospective cohort study was conducted to compare opioid prescribing patterns before and after the release of the recommendations. Data were collected on 184 patients (2017, n = 78; 2018, n = 106) admitted to the Prince of Wales Hospital in November 2017 and 2018, which consisted of demographic data, opioid prescriptions and discharge opioid information. The main outcome is the number of prescriptions of slow-release opioids in 2017 versus 2018 after the recommendations were published. Confounding factors were accounted for using logistic and multiple regression as appropriate. There was a 29% decrease in slow-release opioid prescriptions during hospitalisation ( n = 31, 40% versus n = 12, 11%; P < 0.001) and 17% decrease at discharge ( n = 20, 26% versus n = 9, 9%; P = 0.02) post-publication. After adjusting for confounders, the odds of slow-release opioids being prescribed postoperatively and at discharge reduced by 86% and 88%, respectively (postoperative period: odds ratio 0.14, P < 0.05; discharge: odds ratio 0.12, P < 0.05). In addition, orthopaedic patients were more likely to receive slow-release opioids, consistent with existing literature. As the use of slow-release opioids has been associated with increased harm and protracted opioid use compared to immediate-release opioids, it is hoped that wider dissemination of these recommendations and a change in prescribing practice can be a step towards overcoming the opioid crisis.

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