Abstract：
BACKGROUND: Glucagon-like peptide-1 receptor agonist (GLP-1A) medications are gaining widespread popularity for the treatment of obesity. The optimal use of these drugs in pediatric bariatric populations, and especially in those considering metabolic and bariatric surgery (MBS), is yet to be established. We sought to characterize current practice patterns of GLP-1A use at major pediatric bariatric centers across the United States.
METHODS: We administered an online survey to a purposive sample of 46 surgeons who perform MBS on children and adolescents. Survey questions explored practices prescribing GLP-1As in patients considering MBS, holding them prior to elective operations, and restarting them postoperatively following MBS. Responses were summarized with descriptive statistics and inductive content analysis.
RESULTS: There were 22 responses (48% response rate) representing 19 institutions. Most (86%) respondents do sometimes prescribe GLP-1As for patients considering MBS, but the specific indications vary. Practices for holding GLP-1As preoperatively also vary, from not at all to holding for 2 wk. Over half (55%) of respondents sometimes restart GLP-1As after MBS. Free-response themes included still-evolving preoperative utilization patterns, difficulty with access and insurance coverage, and a lack of data informing GLP-1A use in the pre and postoperative periods.
CONCLUSIONS: Given the increasing use of these medications for weight loss purposes, this substantial variation in practice highlights a need for further research to examine the safest and most effective use of GLP-1As in the pre and postoperative periods and for practice guidelines to standardize care pathways in pediatric bariatric contexts.
METHODS: We administered an online survey to a purposive sample of 46 surgeons who perform MBS on children and adolescents. Survey questions explored practices prescribing GLP-1As in patients considering MBS, holding them prior to elective operations, and restarting them postoperatively following MBS. Responses were summarized with descriptive statistics and inductive content analysis.
RESULTS: There were 22 responses (48% response rate) representing 19 institutions. Most (86%) respondents do sometimes prescribe GLP-1As for patients considering MBS, but the specific indications vary. Practices for holding GLP-1As preoperatively also vary, from not at all to holding for 2 wk. Over half (55%) of respondents sometimes restart GLP-1As after MBS. Free-response themes included still-evolving preoperative utilization patterns, difficulty with access and insurance coverage, and a lack of data informing GLP-1A use in the pre and postoperative periods.
CONCLUSIONS: Given the increasing use of these medications for weight loss purposes, this substantial variation in practice highlights a need for further research to examine the safest and most effective use of GLP-1As in the pre and postoperative periods and for practice guidelines to standardize care pathways in pediatric bariatric contexts.
摘要：
背景：胰高血糖素样肽-1受体激动剂（GLP-1A）药物在肥胖的治疗中越来越受欢迎。这些药物在小儿减肥人群中的最佳使用，尤其是那些考虑代谢和减肥手术（MBS）的人，尚未建立。我们试图描述美国主要儿科减肥中心使用GLP-1A的当前实践模式。
方法：我们对46名对儿童和青少年实施MBS的外科医生进行了一项有目的的在线调查。调查问题探索了在考虑MBS的患者中处方GLP-1As的做法，在选修行动之前拿着它们，并在MBS术后重新启动它们。通过描述性统计和归纳内容分析对反应进行总结。
结果：有22个响应（48％的响应率）代表19个机构。大多数（86％）受访者有时确实为考虑MBS的患者开GLP-1As，但具体的适应症各不相同。术前持有GLP-1As的做法也各不相同，从根本没有到坚持2周。超过一半（55％）的受访者有时会在MBS后重新启动GLP-1A。自由反应主题包括仍在发展的术前利用模式，难以进入和保险范围，并且缺乏在术前和术后期间使用GLP-1A的数据。
结论：鉴于这些药物用于减肥目的的使用越来越多，实践中的这种实质性差异凸显了需要进一步研究以检查GLP-1A在术前和术后期间的最安全和最有效的使用,以及需要制定实践指南以标准化儿科肥胖症患者的护理途径.
方法：我们对46名对儿童和青少年实施MBS的外科医生进行了一项有目的的在线调查。调查问题探索了在考虑MBS的患者中处方GLP-1As的做法，在选修行动之前拿着它们，并在MBS术后重新启动它们。通过描述性统计和归纳内容分析对反应进行总结。
结果：有22个响应（48％的响应率）代表19个机构。大多数（86％）受访者有时确实为考虑MBS的患者开GLP-1As，但具体的适应症各不相同。术前持有GLP-1As的做法也各不相同，从根本没有到坚持2周。超过一半（55％）的受访者有时会在MBS后重新启动GLP-1A。自由反应主题包括仍在发展的术前利用模式，难以进入和保险范围，并且缺乏在术前和术后期间使用GLP-1A的数据。
结论：鉴于这些药物用于减肥目的的使用越来越多，实践中的这种实质性差异凸显了需要进一步研究以检查GLP-1A在术前和术后期间的最安全和最有效的使用,以及需要制定实践指南以标准化儿科肥胖症患者的护理途径.
