Delphi Consensus Among French Obesity Experts on Clinical Recommendations for Drug Prescription in Patients With Severe Obesity

Abstract

Introduction: Although the physiologic alterations seen in obesity often affect the pharmacokinetics and pharmacodynamics of drugs, most clinical trials do not consider these aspects specifically for this population. To date, there is no list of potentially inappropriate medications for patients living with obesity. The aim of this study was to use the Delphi method to identify useful recommendations for the prescription of some specific drug classes in patients living with severe obesity. Methods: We identified five therapeutic groups of drugs using data from the HEGP Clinical Data Warehouse. We conducted a literature review and sought the opinions of local experts to produce potential recommendations. We selected volunteer medical experts from the French network FORCE and set up a two-round Delphi method, concluded by a synthesis meeting, to establish a list of recommendations. In each round, the experts were asked to rate the potential recommendations. Results: Forty-three proposed recommendations were evaluated in the first round. The experts approved four recommendations with a strong consensus and 16 with a relative consensus. In the second round, they approved six recommendations with a strong consensus and 13 with a relative consensus. Conclusion: This is the first study to use the Delphi method to produce a summary of consensus recommendations for several drug classes in patients living with severe obesity. It provides an expert-based consensus on the use of the five most commonly prescribed therapeutic drug classes and develops a list of recommendations for drug prescription in patients living with severe obesity.