A Comparison of Orlistat Use in a Veteran Population: A Pharmacist-Managed Pharmacotherapy Weight-Loss Clinic versus Standard Medical Care

Abstract

Objective:

To determine whether a pharmacist-managed pharmacotherapy weight-loss clinic using orlistat is beneficial in promoting weight loss and reducing cardiovascular risk.

Methods:

A retrospective review of the records of all veterans receiving orlistat was conducted. Patients were assigned to 1 of 2 treatment groups: those enrolled in the pharmacist-managed pharmacotherapy weight-loss clinic (intervention) or those receiving standard medical care (control). Changes in weight and body mass index (BMI) at 6 months were compared with baseline measures. Treatment success, defined as a weight loss of ≥5% of initial body weight, was determined. The impact of weight loss on cardiovascular risk factor reduction was compared within each group. The prevalence of adverse drug reactions was also assessed and compared.

Results:

Forty-seven patients were included in the analysis: 18 and 29 in the intervention and control groups, respectively. Intervention patients lost a mean ± SD of 5.0 ± 6.0 kg by 6 months compared with 2.2 ± 4.7 kg for the controls (p = 0.109). BMI significantly decreased for all patients independent of group assignment (intervention, p = 0.006; control, p = 0.026), yet a between-group comparison revealed no difference (p = 0.140). Five patients (28%) in the intervention group were considered treatment successes versus 4 (14%) in the control group; however, this was not a significant difference (p = 0.274). Total cholesterol and glycosylated hemoglobin were significantly decreased in intervention patients, while control patients demonstrated significant improvement only in total cholesterol. There was no difference in adverse reaction occurrence between groups (p = 0.995).

Conclusions:

Patients enrolled in the pharmacist-managed pharmacotherapy weight-loss clinic lost twice as much weight, and twice as many were considered treatment successes compared with control patients. Intervention patients demonstrated improvement in several cardiovascular risk factors.