Ina Gesquiere1, Patrick Augustijns2, Matthias Lannoo3, Christophe Matthys4,5, Bart Van der Schueren6,7, Veerle Foulon8. 1. Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, O&N2, Herestraat 49, Box 521, 3000, Leuven, Belgium. ina.gesquiere@pharm.kuleuven.be. 2. Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, O&N2, Herestraat 49, Box 921, 3000, Leuven, Belgium. patrick.augustijns@pharm.kuleuven.be. 3. Department of Abdominal Surgery, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium. matthias.lannoo@uzleuven.be. 4. Clinical and Experimental Endocrinology, KU Leuven, O&N 1, Herestraat 49, Box 902, 3000, Leuven, Belgium. christophe.matthys@uzleuven.be. 5. Department of Endocrinology, University Hospitals Leuven, Leuven, Campus Gasthuisberg, Herestraat 49, Box 7003, 3000, Leuven, Belgium. christophe.matthys@uzleuven.be. 6. Clinical and Experimental Endocrinology, KU Leuven, O&N 1, Herestraat 49, Box 902, 3000, Leuven, Belgium. bart.vanderschueren@uzleuven.be. 7. Department of Endocrinology, University Hospitals Leuven, Leuven, Campus Gasthuisberg, Herestraat 49, Box 7003, 3000, Leuven, Belgium. bart.vanderschueren@uzleuven.be. 8. Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, O&N2, Herestraat 49, Box 521, 3000, Leuven, Belgium. veerle.foulon@pharm.kuleuven.be.
Abstract
BACKGROUND: Bariatric surgery is associated not only with weight loss and improvement of comorbidities of obesity but also with short and long-term complications. Preoperative screening and lifelong follow-up of these patients are important to optimize the effect of bariatric surgery and minimize complications. The objective of this study was to create an inventory of the current care offered to bariatric patients before and after surgery in Flemish hospitals, Belgium and to identify barriers for optimal care. METHODS: Semi-structured interviews with healthcare professionals involved in screening and follow-up of bariatric patients in 12 hospitals in Flanders, Belgium were performed. Interviews were transcribed verbatim and analyzed with NVivo 10.0. RESULTS: In each participating hospital, except one, biochemical screening before and after bariatric surgery was performed, but the extent and timing varied between hospitals. In ten hospitals, a standard multivitamin preparation was started in all patients after surgery, but there was a large variation for timing of initiation and duration between hospitals. The interviewees indicated that the knowledge about appropriate dosage and formulation adjustments after surgery was limited. Most of the performed drug adjustments were due to improvement of comorbidities. In 9 out of 12 hospitals, a multidisciplinary team was involved, but the approach varied widely. Only in 3 out of 12 hospitals, eligibility of patients for bariatric surgery was discussed in team meetings. CONCLUSIONS: Strategies to implement existing guidelines are required in order to obtain more uniform, interdisciplinary support for bariatric patients, resulting in an increase of efficiency of surgery and improved patient care.
BACKGROUND: Bariatric surgery is associated not only with weight loss and improvement of comorbidities of obesity but also with short and long-term complications. Preoperative screening and lifelong follow-up of these patients are important to optimize the effect of bariatric surgery and minimize complications. The objective of this study was to create an inventory of the current care offered to bariatric patients before and after surgery in Flemish hospitals, Belgium and to identify barriers for optimal care. METHODS: Semi-structured interviews with healthcare professionals involved in screening and follow-up of bariatric patients in 12 hospitals in Flanders, Belgium were performed. Interviews were transcribed verbatim and analyzed with NVivo 10.0. RESULTS: In each participating hospital, except one, biochemical screening before and after bariatric surgery was performed, but the extent and timing varied between hospitals. In ten hospitals, a standard multivitamin preparation was started in all patients after surgery, but there was a large variation for timing of initiation and duration between hospitals. The interviewees indicated that the knowledge about appropriate dosage and formulation adjustments after surgery was limited. Most of the performed drug adjustments were due to improvement of comorbidities. In 9 out of 12 hospitals, a multidisciplinary team was involved, but the approach varied widely. Only in 3 out of 12 hospitals, eligibility of patients for bariatric surgery was discussed in team meetings. CONCLUSIONS: Strategies to implement existing guidelines are required in order to obtain more uniform, interdisciplinary support for bariatric patients, resulting in an increase of efficiency of surgery and improved patient care.
Authors: Jon B Silverman; Jennifer G Catella; Ali Tavakkolizadeh; Malcolm K Robinson; William W Churchill Journal: Obes Surg Date: 2011-09 Impact factor: 4.129
Authors: M Molly McMahon; Michael G Sarr; Matthew M Clark; Margaret M Gall; James Knoetgen; F John Service; Edward R Laskowski; Daniel L Hurley Journal: Mayo Clin Proc Date: 2006-10 Impact factor: 7.616
Authors: J Picot; J Jones; J L Colquitt; E Gospodarevskaya; E Loveman; L Baxter; A J Clegg Journal: Health Technol Assess Date: 2009-09 Impact factor: 4.014