2020-12-15 OMA Agenda - Board of Trustees

prescribed beyond 12 weeks, it should be done so via a patient’s informed consent, with a patient centered approach, and in a manner that prioritizes safety (Table 4).

Regarding phentermine in fixed combination with topiramate, such a combination can contribute to clinically meaningful weight loss, as well as improvements in blood glucose, blood pressure, and blood lipids. (14) (9) While pulse may increase with phentermine/topiramate, a retrospective cohort study from US insurance billing data suggested no increased risk of major adverse cardiac events among phentermine/topiramate users, although the 95% confidence intervals were large, suggesting wide range of possible values. (15)

What are the practical considerations in prescribing anti-obesity controlled medications (i.e., phentermine) specific to telehealth?

The use of phentermine varies widely in clinical practice, even among obesity medicine specialists. Not everyone prescribes phentermine. Although not required according to its indicated use and prescribing information, some clinicians feel obesity is a major cardiovascular disease risk factor, and thus only prescribe phentermine after a face-to-face clinical encounter and only after an electrocardiogram (although an electrocardiogram is not required according to the prescribing information). Conversely, other clinicians have a low threshold for prescribing phentermine, and routinely do so on a long-term basis. This Position Statement is not intended to advocate how clinicians should treat their patients with obesity. The clinician management of an individual patient is best left to the shared decision making of clinician and patient, using a patient-centered approach. (16) However, it is the intent of this manuscript to highlight issues

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