Bariatric Research Agenda For Canada

Dr. Yves Bolduc (centre) Quebec Minister for Health and Social Services, Dr. Arya Sharma (left) Scientific Director CON-RCO, Dr. Angelo Tremblay (right) 2011 CON-RCO Distinguished Lecturer Award Recipient at the opening of the 2nd National Obesity Summit, Montreal, QC

Dr. Yves Bolduc (centre) Quebec Minister for Health and Social Services, Dr. Arya Sharma (left) Scientific Director CON-RCO, Dr. Angelo Tremblay (right) 2011 CON-RCO Distinguished Lecturer Award Recipient, at the opening of the 2nd National Obesity Summit, Montreal

Regular readers may recall a previous post on a workshop organised by the Canadian Institutes of Health Research (CIHR) Institute for Nutrition, Metabolism and Diabetes (INMD) and the Canadian Obesity Network held in Montreal last year.

The objectives of this workshop, with experts from across Canada, were to

1. define strengths, gaps, and opportunities in Canadian bariatric care research.

2. develop a Canadian bariatric care research agenda that will ultimately improve
health services available to morbidly obese patients.

3. identify opportunities for international collaboration in the area of bariatric care.

4. engage potential research funders that can support an emerging bariatric care research agenda in Canada.

Yesterday, at the opening of the 2nd National Obesity Summit here in Montreal, CIHR-INMD released the final report from this workshop with the following recommendations for a bariatric research agenda.

The following were the top three research priorities identified in terms of knowledge gaps for bariatric care:

Intervention research: understanding variation in response to treatment intervention, matching treatment to need; phenotyping; complications of care; role of co‐morbidity. Topic areas include research on both children and adults.

Health Services and Health Policy research: understanding optimal systems of care focused on continuity of care and integration of pediatric and adult services (i.e., cradle to grave); medical/surgical/rehabilitation/mental health/self‐care; primary care, including collaborative models and intervention strategies for practitioner and practice change.

Access and barriers to treatment: understanding what brings people to treatment and what are the major barriers; weight bias and discrimination including causal factors, impact, and interventions; evaluation of wait‐list management strategies and decision rules for access to bariatric surgery; understanding factors driving demand; forecasting models based on need and demand analyses and projections.

The following were the top three priorities identified in terms of building Canadian research capacity:

Research consortia/collaborations: includes a shift in emphasis to multi‐site, collaborative studies; database development and other capacity building for longitudinal studies.

Outcome and cost assessment: includes an assessment of metabolic and health outcomes beyond weight reduction, such as effects on blood pressure and glucose levels; longer term outcomes includingeconomic impact assessments of both intervention and systems research.

Qualitative/participatory research: required for an exploration of the patient’s lived experience, empowerment, knowledge base and satisfaction with health services and health service models.

The following were the three themes identified in terms of priorities for knowledge translation:

National strategy and standardization of care: decision‐trees for access to surgery; assessment and outcome measures; waiting list prioritization; guidelines for bariatric care team size and composition; accreditation and evaluation; and remuneration of health care providers for delivery of obesity care.

Environmental scans: assessing “what is out there”, who is doing what beyond surgery; level of collaboration and partnerships; building upon the pediatric scan undertaken in Alberta and the adult scan in Quebec.

Engaging policy makers: improving access to existing data; engaging earlier in the research process, including study design; providing better costing data for the development of relevant business cases, including cost effectiveness of treatment interventions (health costs, productivity).

It is anticipated that CIHR-INMD will now prepare targeted requests for applications to address these identified research and capacity building priorities.

The release of this report certainly demonstrates the intent of CIHR to take the needs of the the bariatric population in Canada very seriously.

Even a quick glance at the research excellence present here at this Summit should certainly reassure CIHR that Canadian researchers are ready and willing to address this important research agenda.

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Montreal, Quebec