Oral Presentation ANZOS-OSSANZ-AOCO Joint Annual Scientific Meeting 2017

Annual Reviews in Bariatric Surgery: Patient Perspectives and Progress (#73)

Clare Tancabel 1 , Louise A Fish 1 , Susan F Taylor 1 , Ruth E Blackham 1 , Jeffrey M Hamdorf 1
  1. Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, Perth, WA, Australia

Background:

A lack of follow-up post-bariatric surgery is associated with lower excess weight loss.1-3 Attrition from follow-up represents a significant problem in many weight loss programs.4

This study sought to explore the qualitative factors which impact upon attendance at annual review following bariatric surgery.

Method:

Of a 12 month (2013/14) cohort of 221 bariatric patients, 167 met inclusion criteria. Open and closed questions on annual review were posed to 41 of the patients by semi-structuted telephone interview. Emergent cluster themes were identified and pursued. Attendance at annual review was then cross referenced against weight loss , BMI change, BAROS, AUDIT-C and comorbidity status.

Results:

Patients who attended for their annual review (19 interviewees) spoke about “following the weight loss plan” of the practice, expressed proactive ideas (wanted to be “kept on track,” “catch problems early”), and wanted to “show progress” and receive encouragement from the practice. Patients who did not attend annual review (22 interviewees) spoke about practicalities (time and geography), perceived lack of reminders to attend and having “no issues” to report to medical staff. It was found that patients who did not attend annual review had significantly higher %EWL at 3 years post-surgery (78% [68-89] vs 58% [46-71]; p-value 0.021, Student’s T test) and a significantly lower BMI (29 [27-31] vs 32 [29-35]; p-value 0.037, Student’s T test). No other numerical end points were significant.

Conclusion:

Non-attendees at annual review had lost more weight, had lower BMIs and spoke largely about practicalities barring them from follow-up. We postulate that patients who were progressing satisfactorily with weight loss, without significant issues, were not prioritising follow-up.

Numerical measures were likely impacted by small sample size. Further studies must include larger sample sizes such that numerical end-points can be accurately assessed and qualitative data can be further explored.

  1. 1. Gould JC, Beverstein G, Reinhardt S, Garren MJ. Impact of routine and long-term follow-up on weight loss after laparoscopic gastric bypass. Surgery for Obesity and Related Diseases. 2007;3(6):627-630.
  2. 2. Te Riele W, Boerma D, Wiezer M, Borel Rinkes I, van Ramshorst B. Long‐term results of laparoscopic adjustable gastric banding in patients lost to follow‐up. British Journal of Surgery. 2010;97(10):1535-1540.
  3. 3. Sivagnanam P, Rhodes M. The importance of follow-up and distance from centre in weight loss after laparoscopic adjustable gastric banding. Surgical endoscopy. 2010;24(10):2432-2438.
  4. 4. Moroshko I, Brennan L, O’Brien P. Predictors of attrition in bariatric aftercare: a systematic review of the literature. Obesity surgery. 2012;22(10):1640-1647.