Top

Published in:

01-02-2014 | Original Contributions

Lack of Adherence to Follow-Up Visits After Bariatric Surgery: Reasons and Outcome

Authors: Pablo Vidal, José Manuel Ramón, Alberto Goday, Alejandra Parri, Xènia Crous, Lourdes Trillo, Manuel Pera, Luis Grande

Published in: Obesity Surgery | Issue 2/2014

Abstract

Background

A substantial number of patients undergoing bariatric surgery are lost to follow-up for unknown reasons, which may cause an overestimation of the benefits of operation. The aim of this study was to identify the reasons of failure to attend controls after bariatric surgery and the relationship with poor weight loss.

Methods

A retrospective analysis of a prospective database including all patients undergoing bariatric surgery from January 2004 to February 2012 was performed. Nonadherence was defined as missing any scheduled control visit for more than 6 months. Contact was attempted (mail, telephone, and e-mail), and responders were requested to complete a questionnaire.

Results

Forty-six (17.5 %) out of 263 patients were considered nonadherent. Thirty-three (71.7 %) of these patients completed the questionnaire. The main reasons for nonadherence were work- (36.4 %) and family-related (18.2 %) problems or having moved outside the city or to the country (15.2 %). The percentage of nonadherent patients aged ≤45 years was greater as compared with those aged >45 years [28 (60.1 %) vs 18 (42.2 %), respectively, P = 0.034]. Likewise, of the 30 patients with unsuccessful weight loss (<50 % EWL), seven (30.4 %) were in the nonadherent group while 23 (10.6 %) in the adherent group (P = 0.046). Finally, 96.9 % of patients were completely satisfied with surgery and would recommend the procedure to other morbid obese patients.

Conclusion

The nonadherence rate to follow-up visits after bariatric surgery was 17.5 %, mainly associated with work-related problems. Nonadherence was greater in patients aged ≤45 years and in those with poor weight loss.

Franco JV, Ruiz PA, Palermo M, et al. A review of studies comparing three laparoscopic procedures in bariatric surgery: sleeve gastrectomy, Roux-en-Y gastric bypass and adjustable gastric banding. Obes Surg. 2011;21:1458–68.PubMedCrossRef

Kehagias I, Karamanakos SN, Argentou M, et al. Randomized clinical trial of laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy for the management of patients with BMI < 50 kg/m2. Obes Surg. 2011;21:1650–6.PubMedCrossRef

Sanchez-Santos R, Masdevall C, Baltasar A, et al. Short- and mid-term outcomes of sleeve gastrectomy for morbid obesity: the experience of the Spanish National Registry. Obes Surg. 2009;19:1203–10.PubMedCrossRef

Bohdjalian A, Langer FB, Shakeri-Leidenmühler S, et al. Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin. Obes Surg. 2010;20:535–40.PubMedCrossRef

Srinivasa S, Hill LS, Sammour T, et al. Early and mid-term outcomes of single-stage laparoscopic sleeve gastrectomy. Obes Surg. 2010;20:1484–90.PubMedCrossRef

Chopra A, Chao E, Etkin Y, et al. Laparoscopic sleeve gastrectomy for obesity: can it be considered a definitive procedure? Surg Endosc. 2012;26:831–7.PubMedCrossRef

Vidal P, Ramon JM, Goday A, et al. Laparoscopic gastric bypass versus laparoscopic sleeve gastrectomy as a definitive surgical procedure for morbid obesity. Mid-term results. Obes Surg. 2013;23:292–9.PubMedCrossRef

Harper J, Madan AK, Ternovits CA, et al. What happens to patients who do not follow-up after bariatric surgery? Am Surg. 2007;73:181–4.PubMed

Ma Y, Pagoto SL, Olendzki BC, et al. Predictors of weight status following laparoscopic gastric bypass. Obes Surg. 2006;16:1227–31.PubMedCrossRef

10.

Leyba JL, Aulestia SN, Llopis SN. Laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy for the treatment of morbid obesity. A prospective study of 117 patients. Obes Surg. 2011;21:212–6.PubMedCrossRef

11.

Eid GM, Brethauer S, Mattar SG, et al. Laparoscopic sleeve gastrectomy for super obese patients: forty-eight percent excess weight loss after 6 to 8 years with 93% follow-up. Ann Surg. 2012;256:262–5.PubMedCrossRef

12.

Gould JC, Beverstein G, Reinhardt S, et al. Impact of routine and long-term follow-up on weight loss after laparoscopic gastric bypass. Surg Obes Relat Dis. 2007;3:627–30.PubMedCrossRef

13.

Pontiroli AE, Fossati A, Vedani P, et al. Post-surgery adherence to scheduled visits and compliance, more than personality disorders, predict outcome of bariatric restrictive surgery in morbidly obese patients. Obes Surg. 2007;17:1492–7.PubMedCrossRef

14.

Shen R, Dugay G, Rajaram K, et al. Impact of patient follow-up on weight loss after bariatric surgery. Obes Surg. 2004;14:514–9.PubMedCrossRef

15.

Hubbard VS, Hall WH. Gastrointestinal surgery for severe obesity. Obes Surg. 1991;1:257–65.PubMedCrossRef

16.

Nogués X, Goday A, Peña MJ, et al. Bone mass loss after sleeve gastrectomy: a prospective comparative study with gastric bypass. Cir Esp. 2010;88:103–9.PubMedCrossRef

17.

Benaiges D, Goday A, Ramon JM, et al. Laparoscopic sleeve gastrectomy and laparoscopic gastric bypass are equally effective for reduction of cardiovascular risk in severely obese patients at one year of follow-up. Surg Obes Relat Dis. 2011;7:575–80.PubMedCrossRef

18.

Ramón JM, González CG, Dorcaratto D, et al. Quality of food intake after bariatric surgery: vertical gastrectomy versus gastric bypass. Cir Esp. 2012;90:95–101.PubMedCrossRef

19.

Ramón JM, Salvans S, Crous X, et al. Effect of Roux-en-Y gastric bypass vs sleeve gastrectomy on glucose and gut hormones: a prospective randomised trial. J Gastrointest Surg. 2012;16:1116–22.PubMedCrossRef

20.

Benaiges D, Flores-Le-Roux JA, Pedro-Botet J, et al. Impact of restrictive (sleeve gastrectomy) vs hybrid bariatric surgery (Roux-en-Y gastric bypass) on lipid profile. Obes Surg. 2012;22:1268–75.PubMedCrossRef

21.

Benaiges D, Flores Le-Roux JA, Pedro-Botet J, et al. Sleeve gastrectomy and Roux-en-Y gastric bypass are equally effective in correcting insulin resistance. Int J Surg. 2013;11:309–13.PubMedCrossRef

22.

Keren D, Matter I, Rainis T, et al. Getting the most from the sleeve: the importance of post-operative follow-up. Obes Surg. 2011;21:1887–93.PubMedCrossRef

23.

Livhits M, Mercado C, Yermilov I, et al. Behavioral factors associated with successful weight loss after gastric bypass. Am Surg. 2010;76:1139–42.PubMed

24.

Stegen S, Derave W, Calders P, et al. Physical fitness in morbidly obese patients: effect of gastric bypass surgery and exercise training. Obes Surg. 2011;21:61–70.PubMedCrossRef

25.

Toussi R, Fujioka K, Coleman KJ. Pre- and postsurgery behavioral compliance, patient health, and postbariatric surgical weight loss. Obesity (Silver Spring). 2009;17:996–1002.CrossRef

Title: Lack of Adherence to Follow-Up Visits After Bariatric Surgery: Reasons and Outcome
Authors: Pablo Vidal
José Manuel Ramón
Alberto Goday
Alejandra Parri
Xènia Crous
Lourdes Trillo
Manuel Pera
Luis Grande
Publication date: 01-02-2014
Publisher: Springer US
Published in: Obesity Surgery / Issue 2/2014
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-013-1094-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Lack of Adherence to Follow-Up Visits After Bariatric Surgery: Reasons and Outcome

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 2/2014

Six-Month Intragastric Balloon Treatment for Obesity Improves Lung Function, Body Composition, and Metabolic Syndrome

The Duodenal–Jejunal Bypass Liner for the Treatment of Type 2 Diabetes Mellitus and/or Obesity: a Systematic Review

Changes in Intestinal Permeability after Roux-en-Y Gastric Bypass

Physical Activity After Surgically Obtained Weight Loss: Study with a SenseWear Armband in Subjects Undergoing Biliopancreatic Diversion

Can Bariatric Surgery be Performed Safely in Patients with Severe Treatment-Resistant Asthma?

Prophylaxis of Venous Thromboembolism with Low Molecular Weight Heparin in Bariatric Surgery: a Prospective, Randomised Pilot Study Evaluating Two Doses of Parnaparin (BAFLUX Study)