{
  "abstract": "Recent evidence demonstrates that Tirzepatide - a dual gastric inhibitory polypeptide and glucagon-like peptide-1 receptor agonist - is effective in supporting weight loss in obesity and in reducing the risk of future major cardiovascular events. In response, NICE has approved its use for patients who meet specific criteria: a BMI greater than 40, the presence of four out of five weight-related comorbidities (obstructive sleep apnoea, type 2 diabetes mellitus, hypertension, hyperlipidaemia, and cardiovascular disease), and a willingness to engage with weight-management services.Barnsley Hospital NHS Foundation Trust serves a population with disproportionately high levels of deprivation, obesity, and preventable cardiovascular mortality. Although long-term plans include the introduction of Tirzepatide prescribing within primary care, current access within the NHS is limited to Tier 3 weight-management services across South Yorkshire. In addition, referral criteria and pathways for these services were not well understood within the Cardiology outpatient department (OPD). An audit was therefore undertaken to determine the proportion of Cardiology OPD patients eligible for specialist weight-management services, including access to Tirzepatide, and to model how eligibility is expected to change in line with planned criteria reductions in June 2026 (BMI >35 with four of five comorbidities), March 2027 (BMI >40 with three of five comorbidities), and by 2036 (BMI >35 with one comorbidity).Data was collected from 168 patients attending the Cardiology OPD between 3rd and 14th November 2020. Five patients were excluded due to insufficient data. Table 1 summarises baseline characteristics and the number of patients eligible for Tirzepatide under current and future criteria. Only two patients were already receiving Tirzepatide, neither of whom met current eligibility thresholds; both were prescribed the medication for poorly controlled diabetes. At present, 2.5% of patients meet eligibility criteria for Tirzepatide. This proportion is projected to rise to 7.5% by March 2027 and 20% by 2036. Figure 1 illustrates changes in eligibility by age and sex between 2020 and 2036, assuming a stable population profile, and demonstrates a significantly greater future increase in eligibility among females aged 51–60 compared with males (p = 0.040).These findings highlight that an increasingly large proportion of patients attending the Cardiology OPD are obese and living with multiple comorbidities, and will therefore meet criteria for medical weight management, including Tirzepatide, in the coming years. In response, a brief teaching session on weight-management pathways was delivered to medical staff, and posters outlining referral criteria and processes were displayed within the OPD. Future work will involve monitoring changes in patient eligibility as criteria evolve over the next year and evaluating uptake of Tirzepatide amongst those who become eligible.Abstract 175 Figure 1Age- and sex-stratified distribution of cardiology outpatients by BMI category and eligibility for weight-management interventions. Stacked column charts show the number of patients in each age group for males (blue, left panels) and females (pink, right panels). The upper panels represent eligibility under current criteria (Nov 2020), and the lower panels show projected eligibility under criteria anticipated in 2036. Within each age group, columns are stacked to indicate patients with normal BMI, those eligible for tirzepatide via private prescription, those eligible for NHS Tier 2 weight-management services, and those eligible for tirzepatide on the NHS. Although eligibility increases across all age groups between 2020 and 2036, a notably higher proportion of females aged 51–60 years are projected to meet criteria compared with males by 2036 (p=0.040)Abstract 175 Table 1Number of patients meeting the inclusion criteria with their respective mean (± SD) age, BMI, and current versus future eligibility for Tirzepatide, split by genderMaleFemaleNumber of Patients86/8777/81Age (Yrs)67.3 ± 16.162.4 ± 18.6BMI30.2 ± 6.430.1 ± 6.6Patients eligible for Tirzepatide by NICE criteriaNov 20203/861/77June 20267/86*1/77Mar 20278/864/77By 203617/8615/77*2 of these patients already prescribed Tirzepatide for poor diabetes control",
  "authors": [
    {
      "affiliations": [
        "Barnsley Hospital NHS Foundation Trust, Barnsley, United Kingdom"
      ],
      "name": "Kelly Wright"
    },
    {
      "affiliations": [
        "Barnsley Hospital NHS Foundation Trust, Barnsley, United Kingdom"
      ],
      "name": "Uma Velupandian"
    }
  ],
  "title": "175 Eligibility and referral to weight management services in a cardiology outpatient department",
  "uid": "6ee0a74d-90e9-500a-b591-9113f2714e4d"
}