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Published in: Obesity Surgery 5/2020

01-05-2020 | Bariatric Surgery | Original Contributions

Understanding the Bariatric Patient Perspective in the National Patient-Centered Clinical Research Network (PCORnet) Bariatric Study

Authors: Karen J. Coleman, David G. Schlundt, Kemberlee R. Bonnet, Kimberly J. Holmquist, Jennifer Dunne, Elizabeth Crull, Beatrice Y. Hanaoka, Michelle R. Lent, Joe Nadglowski, Louisa Sylvia, Shilpa Venkatachalam, Stavra A. Xanthakos, Roni Zeiger, David Arterburn, Neely Williams, Anita Courcoulas, Jane Anau, Kathleen M. McTigue, Cynthia Blalock, Elisha Malanga, James McClay, Corrigan L. McBride, David Schlundt, Ana Emiliano, Rabih Nemr, Kathleen McTigue, Anita Courcoulas, Stavra A. Xanthakos, Marc Michalsky, Karen J. Coleman, Sameer Murali, Ali Tavakkoli, Nirav Desai, Caroline Apovian, Jeanne Clark, Elizabeth Nauman, Elizabeth Cirielli, Joe Nadglowski, Tammy St. Clair, Julie Tice, Joseph Vitello, Roni Zeiger, David Arterburn, Jane Anau, Cheri Janning, Neely Williams

Published in: Obesity Surgery | Issue 5/2020

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Abstract

Background

In 2016, the Patient-Centered Outcomes Research Institute funded the National Patient Centered Clinical Research Network (PCORnet) Bariatric Study (PBS). Understanding the experience of postoperative patients was a key component of this study.

Methods

Nine focus groups were conducted in Southern California, Louisiana, Pennsylvania, and Ohio and in a national advocacy conference for patients with obesity. Participants were identified and recruited in both clinical and community settings. Focus group transcripts were analyzed using an iterative inductive-deductive approach to identify global overarching themes.

Results

There were 76 focus group participants. Participants were mostly women (81.4%), had primarily undergone gastric sleeve (47.0%), were non-Hispanic white (51.4%), had some college education (44.3%), and made $100,000 annual income or less (65.7%). Qualitative findings included negative reactions patients received from friends, family, and co-workers once they disclosed that they had bariatric surgery to lose weight; and barriers to follow-up care included insurance coverage, emotional and situational challenges, and physical pain limiting mobility.

Conclusions

These findings confirm the other qualitative findings in this area. The approach to bariatric surgery should be expanded to provide long-term comprehensive care that includes in-depth postoperative lifetime monitoring of emotional and physical health.
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Literature
1.
go back to reference Khosravi-Largani M, Nojomi M, Aghili R, et al. Evaluation of all types of metabolic bariatric surgery and its consequences: a systematic review and meta-analysis. Obes Surg. 2019;29:651–90.CrossRefPubMed Khosravi-Largani M, Nojomi M, Aghili R, et al. Evaluation of all types of metabolic bariatric surgery and its consequences: a systematic review and meta-analysis. Obes Surg. 2019;29:651–90.CrossRefPubMed
2.
go back to reference Ribaric G, Buchwald JN, McGlennon TW. Diabetes and weight in comparative studies of bariatric surgery vs conventional medical therapy: a systematic review and meta-analysis. Obes Surg. 2014;24:437–55.CrossRefPubMed Ribaric G, Buchwald JN, McGlennon TW. Diabetes and weight in comparative studies of bariatric surgery vs conventional medical therapy: a systematic review and meta-analysis. Obes Surg. 2014;24:437–55.CrossRefPubMed
3.
go back to reference Gasoyan H, Tajeu G, Halpern MT, et al. Reasons for underutilization of bariatric surgery: the role of insurance benefit design. Surg Obes Relat Dis. 2019;15:146–51.CrossRefPubMed Gasoyan H, Tajeu G, Halpern MT, et al. Reasons for underutilization of bariatric surgery: the role of insurance benefit design. Surg Obes Relat Dis. 2019;15:146–51.CrossRefPubMed
4.
go back to reference Courcoulas AP, Christian NJ, Belle SH, et al. Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity. JAMA. 2013;310:2416–25.PubMedPubMedCentral Courcoulas AP, Christian NJ, Belle SH, et al. Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity. JAMA. 2013;310:2416–25.PubMedPubMedCentral
5.
go back to reference Ortega E, Morinigo R, Flores L, et al. Predictive factors of excess body weight loss 1 year after laparoscopic bariatric surgery. Surg Endosc. 2012;26:1744–50.CrossRefPubMed Ortega E, Morinigo R, Flores L, et al. Predictive factors of excess body weight loss 1 year after laparoscopic bariatric surgery. Surg Endosc. 2012;26:1744–50.CrossRefPubMed
6.
go back to reference Aguera Z, Garcia-Ruiz-de-Gordejuala A, Vilarrasa N, et al. Psychological and personality predictors of weight loss and comorbid metabolic changes after bariatric surgery. Eur Eat Disord Rev. 2015;23:509–19.CrossRefPubMed Aguera Z, Garcia-Ruiz-de-Gordejuala A, Vilarrasa N, et al. Psychological and personality predictors of weight loss and comorbid metabolic changes after bariatric surgery. Eur Eat Disord Rev. 2015;23:509–19.CrossRefPubMed
7.
go back to reference Coleman KJ, Huang YC, Hendee F, et al. Three-year weight outcomes from a bariatric surgery registry in a large integrated healthcare system. Surg Obes Relat Dis. 2014;10:396–403.CrossRefPubMed Coleman KJ, Huang YC, Hendee F, et al. Three-year weight outcomes from a bariatric surgery registry in a large integrated healthcare system. Surg Obes Relat Dis. 2014;10:396–403.CrossRefPubMed
8.
go back to reference Coleman KJ, Huang YC, Koebnick C, et al. Metabolic syndrome is less likely to resolve in Hispanics and non-Hispanic blacks after bariatric surgery. Ann Surg. 2014;259:279–85.CrossRefPubMed Coleman KJ, Huang YC, Koebnick C, et al. Metabolic syndrome is less likely to resolve in Hispanics and non-Hispanic blacks after bariatric surgery. Ann Surg. 2014;259:279–85.CrossRefPubMed
9.
go back to reference Fisher D, Coleman KJ, Arterburn DE, et al. Mental illness in bariatric surgery: a cohort study from the PORTAL network. Obesity. 2017;25:850–6.CrossRefPubMed Fisher D, Coleman KJ, Arterburn DE, et al. Mental illness in bariatric surgery: a cohort study from the PORTAL network. Obesity. 2017;25:850–6.CrossRefPubMed
10.
go back to reference Admiraal WM, Celik F, Gerdes VE, et al. Ethnic differences in weight loss and diabetes remission after bariatric surgery: a meta-analysis. Diabetes Care. 2012;35:1951–8.CrossRefPubMedPubMedCentral Admiraal WM, Celik F, Gerdes VE, et al. Ethnic differences in weight loss and diabetes remission after bariatric surgery: a meta-analysis. Diabetes Care. 2012;35:1951–8.CrossRefPubMedPubMedCentral
11.
go back to reference Toussi R, Fujioka K, Coleman KJ. Pre- and postsurgery behavioral compliance, patient health, and postbariatric surgical weight loss. Obesity. 2009;17:996–1002.CrossRefPubMed Toussi R, Fujioka K, Coleman KJ. Pre- and postsurgery behavioral compliance, patient health, and postbariatric surgical weight loss. Obesity. 2009;17:996–1002.CrossRefPubMed
12.
go back to reference Livhits M, Mercado C, Yermilov I, et al. Preoperative predictors of weight loss following bariatric surgery: systematic review. Obes Surg. 2012;22:70–89.CrossRefPubMed Livhits M, Mercado C, Yermilov I, et al. Preoperative predictors of weight loss following bariatric surgery: systematic review. Obes Surg. 2012;22:70–89.CrossRefPubMed
13.
go back to reference Wimmelmann CL, Dela F, Mortensen EL. Psychological predictors of weight loss after bariatric surgery: a review of the recent research. Obes Res Clin Pract. 2014;8:e299–313.CrossRefPubMed Wimmelmann CL, Dela F, Mortensen EL. Psychological predictors of weight loss after bariatric surgery: a review of the recent research. Obes Res Clin Pract. 2014;8:e299–313.CrossRefPubMed
16.
go back to reference Clark SM, Saules KK, Schuh LM, et al. Associations between relationship stability, relationship quality, and weight loss outcomes among bariatric surgery patients. Eat Behav. 2014;15:670–2.CrossRefPubMed Clark SM, Saules KK, Schuh LM, et al. Associations between relationship stability, relationship quality, and weight loss outcomes among bariatric surgery patients. Eat Behav. 2014;15:670–2.CrossRefPubMed
17.
go back to reference Livhits M, Mercado C, Yermilov I, et al. Patient behaviors associated with weight regain after laparoscopic gastric bypass. Obes Res Clin Pract. 2011;5:e169–266.CrossRefPubMed Livhits M, Mercado C, Yermilov I, et al. Patient behaviors associated with weight regain after laparoscopic gastric bypass. Obes Res Clin Pract. 2011;5:e169–266.CrossRefPubMed
18.
go back to reference Livhits M, Mercado C, Yermilov I, et al. Is social support associated with greater weight loss after bariatric surgery? A systematic review. Obes Rev. 2011;12:142–8.CrossRefPubMed Livhits M, Mercado C, Yermilov I, et al. Is social support associated with greater weight loss after bariatric surgery? A systematic review. Obes Rev. 2011;12:142–8.CrossRefPubMed
19.
go back to reference Mitchell JE, Christian NJ, Flum DR, et al. Postoperative behavioral variables and weight change 3 years after bariatric surgery. JAMA Surg. 2016;151:752–7.CrossRefPubMedPubMedCentral Mitchell JE, Christian NJ, Flum DR, et al. Postoperative behavioral variables and weight change 3 years after bariatric surgery. JAMA Surg. 2016;151:752–7.CrossRefPubMedPubMedCentral
20.
go back to reference Toh S, Rasmussen-Torvik LJ, Harmata EE, et al. The national patient-centered clinical research network (PCORnet) bariatric study cohort: rationale, methods and baseline characteristics. JMIR Res Protoc. 2017;6:e222–40.CrossRefPubMedPubMedCentral Toh S, Rasmussen-Torvik LJ, Harmata EE, et al. The national patient-centered clinical research network (PCORnet) bariatric study cohort: rationale, methods and baseline characteristics. JMIR Res Protoc. 2017;6:e222–40.CrossRefPubMedPubMedCentral
21.
go back to reference Coulman KD, MacKichan F, Blazeby JM, et al. Patient experiences of outcomes of bariatric surgery: a systematic review and qualitative synthesis. Obes Rev. 2017;18:547–59.CrossRefPubMedPubMedCentral Coulman KD, MacKichan F, Blazeby JM, et al. Patient experiences of outcomes of bariatric surgery: a systematic review and qualitative synthesis. Obes Rev. 2017;18:547–59.CrossRefPubMedPubMedCentral
22.
go back to reference Successful Focus Groups. In: Morgan DL, editor. Advancing the State of the Art. Newbury Park: Sage Publications, Inc.; 1993. Successful Focus Groups. In: Morgan DL, editor. Advancing the State of the Art. Newbury Park: Sage Publications, Inc.; 1993.
23.
go back to reference Goodenough W. Describing a culture: description and comparison in cultural anthropology. Cambridge: Cambridge University Press; 1970. Goodenough W. Describing a culture: description and comparison in cultural anthropology. Cambridge: Cambridge University Press; 1970.
24.
go back to reference Absalom E, Chambers R, Francis S, et al. Sharing our concerns and looking to the future. PLA Notes. 1995;22:5–10. Absalom E, Chambers R, Francis S, et al. Sharing our concerns and looking to the future. PLA Notes. 1995;22:5–10.
25.
go back to reference Elder JP, Ayala GX, Harris S. Theories and intervention approaches to health-behavior change in primary care. Am J Prev Med. 1999;17:275–84.CrossRefPubMed Elder JP, Ayala GX, Harris S. Theories and intervention approaches to health-behavior change in primary care. Am J Prev Med. 1999;17:275–84.CrossRefPubMed
26.
go back to reference Noar SM, Zimmerman RS. Health behavior theory and cumulative knowledge regarding health behaviors: are we moving in the right direction? Health Educ Res. 2005;20:275–90.CrossRefPubMed Noar SM, Zimmerman RS. Health behavior theory and cumulative knowledge regarding health behaviors: are we moving in the right direction? Health Educ Res. 2005;20:275–90.CrossRefPubMed
27.
go back to reference Wykowski K, Krouse HJ. Self-care predictors for success post-bariatric surgery: a literature review. Gastroenterol Nurs. 2013;36:129–35.CrossRefPubMed Wykowski K, Krouse HJ. Self-care predictors for success post-bariatric surgery: a literature review. Gastroenterol Nurs. 2013;36:129–35.CrossRefPubMed
28.
go back to reference Michie S, Abraham C, Whittington C, et al. Effective techniques in healthy eating and physical activity interventions: a meta-regression. Health Psychol. 2009;28:690–701.CrossRefPubMed Michie S, Abraham C, Whittington C, et al. Effective techniques in healthy eating and physical activity interventions: a meta-regression. Health Psychol. 2009;28:690–701.CrossRefPubMed
29.
go back to reference Wing RR, Papandonatos G, Fava JL, et al. Maintaining large weight losses: the role of behavioral and psychological factors. J Consult Clin Psychol. 2008;76:1015–21.CrossRefPubMedPubMedCentral Wing RR, Papandonatos G, Fava JL, et al. Maintaining large weight losses: the role of behavioral and psychological factors. J Consult Clin Psychol. 2008;76:1015–21.CrossRefPubMedPubMedCentral
30.
go back to reference Wing RR, Tate DF, Gorin AA, et al. A self-regulation program for maintenance of weight loss. N Engl J Med. 2006;355:1563–71.CrossRefPubMed Wing RR, Tate DF, Gorin AA, et al. A self-regulation program for maintenance of weight loss. N Engl J Med. 2006;355:1563–71.CrossRefPubMed
31.
32.
go back to reference Metzgar CJ, Preston AG, Miller DL, et al. Facilitators and barriers to weight loss and weight loss maintenance: a qualitative exploration. J Hum Nutr Diet. 2015;28:593–603.CrossRefPubMed Metzgar CJ, Preston AG, Miller DL, et al. Facilitators and barriers to weight loss and weight loss maintenance: a qualitative exploration. J Hum Nutr Diet. 2015;28:593–603.CrossRefPubMed
33.
go back to reference Trainer S, Benjamin T. Elective surgery to save my life: rethinking the “choice” in bariatric surgery. J Adv Nurs. 2016;73:8934–04. Trainer S, Benjamin T. Elective surgery to save my life: rethinking the “choice” in bariatric surgery. J Adv Nurs. 2016;73:8934–04.
34.
go back to reference Koball AM, Jester DJ, Domoff SE, et al. Examination of bariatric surgery Facebook support groups: a content analysis. Surg Obes Relat Dis. 2017;13:1369–75.CrossRefPubMed Koball AM, Jester DJ, Domoff SE, et al. Examination of bariatric surgery Facebook support groups: a content analysis. Surg Obes Relat Dis. 2017;13:1369–75.CrossRefPubMed
35.
go back to reference Liebl L, Barnason S, Hudson DB. Awakening: a qualitative study on maintaining weight loss after bariatric surgery. J Clin Nurs. 2016;25:951–61.CrossRefPubMed Liebl L, Barnason S, Hudson DB. Awakening: a qualitative study on maintaining weight loss after bariatric surgery. J Clin Nurs. 2016;25:951–61.CrossRefPubMed
37.
go back to reference Lauti M, Stevenson S, Hill AG, et al. Patient perspectives about follow-up care and weight regain following sleeve gastrectomy. Obes Surg. 2016;26:2724–31.CrossRefPubMed Lauti M, Stevenson S, Hill AG, et al. Patient perspectives about follow-up care and weight regain following sleeve gastrectomy. Obes Surg. 2016;26:2724–31.CrossRefPubMed
38.
go back to reference Khorgami Z, Shoar S, Andalib A, et al. Trends in utilization of bariatric surgery, 2010-2014: sleeve gastrectomy dominates. Surg Obes Relat Dis. 2017;13:774–9.CrossRefPubMed Khorgami Z, Shoar S, Andalib A, et al. Trends in utilization of bariatric surgery, 2010-2014: sleeve gastrectomy dominates. Surg Obes Relat Dis. 2017;13:774–9.CrossRefPubMed
Metadata
Title
Understanding the Bariatric Patient Perspective in the National Patient-Centered Clinical Research Network (PCORnet) Bariatric Study
Authors
Karen J. Coleman
David G. Schlundt
Kemberlee R. Bonnet
Kimberly J. Holmquist
Jennifer Dunne
Elizabeth Crull
Beatrice Y. Hanaoka
Michelle R. Lent
Joe Nadglowski
Louisa Sylvia
Shilpa Venkatachalam
Stavra A. Xanthakos
Roni Zeiger
David Arterburn
Neely Williams
Anita Courcoulas
Jane Anau
Kathleen M. McTigue
Cynthia Blalock
Elisha Malanga
James McClay
Corrigan L. McBride
David Schlundt
Ana Emiliano
Rabih Nemr
Kathleen McTigue
Anita Courcoulas
Stavra A. Xanthakos
Marc Michalsky
Karen J. Coleman
Sameer Murali
Ali Tavakkoli
Nirav Desai
Caroline Apovian
Jeanne Clark
Elizabeth Nauman
Elizabeth Cirielli
Joe Nadglowski
Tammy St. Clair
Julie Tice
Joseph Vitello
Roni Zeiger
David Arterburn
Jane Anau
Cheri Janning
Neely Williams
Publication date
01-05-2020
Publisher
Springer US
Published in
Obesity Surgery / Issue 5/2020
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-020-04404-8

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