Wendy A Brown1,2,3, Paul R Burton4,5,6, Kalai Shaw4, Brittany Smith5, Shelley Maffescioni4, Bernadette Comitti7, Michael A Cowley8, Cheryl Laurie5, Andrew Way7, Peter Nottle4. 1. Upper Gastrointestinal Surgical Service, The Alfred, Commercial Road, Melbourne, 3004, Australia. Wendy.Brown@monash.edu. 2. Centre for Obesity Research and Education, Monash University School of Public Health and Preventative Medicine, Level 6, 99 Commercial Road, Melbourne, 3004, Australia. Wendy.Brown@monash.edu. 3. Department of Surgery, Central Clinical School, Monash University, Level 6, 99 Commercial Road, Melbourne, 3004, Australia. Wendy.Brown@monash.edu. 4. Upper Gastrointestinal Surgical Service, The Alfred, Commercial Road, Melbourne, 3004, Australia. 5. Centre for Obesity Research and Education, Monash University School of Public Health and Preventative Medicine, Level 6, 99 Commercial Road, Melbourne, 3004, Australia. 6. Department of Surgery, Central Clinical School, Monash University, Level 6, 99 Commercial Road, Melbourne, 3004, Australia. 7. CEO's office/Surgical Services, The Alfred, Commercial Road, Melbourne, 3004, Australia. 8. Monash Obesity and Diabetes Institute, Monash University, Wellington Road, Clayton, 3800, Australia.
Abstract
BACKGROUND: We designed an assessment and education program which was delivered to patients prior to first outpatient appointment for bariatric surgery. We hypothesised that this program would streamline care and would lead to improved weight loss following bariatric surgery. METHODS: The program incorporates a structured general practitioners (GP) review, a patient information evening and an on-line learning package. It was introduced in September 2012. Patient flow through the program was recorded. Outcomes of the new program were compared with contemporaneously treated patients who did not undertake the pre-hospital program. RESULTS: All 636 patients on the waiting list for first appointment at the Alfred Health bariatric surgery clinic were invited to participate. There were 400 patients ultimately removed from the waiting list for first appointment. Of the remaining 236 patients, 229 consented to participate in the new program. The mean BMI was 47.8 ± 9.2. The fail to attend first appointment rate dropped from 12 to 2.1 %. At 12 months post-bariatric surgery, patients who undertook the new program (n = 82) had a mean excess weight loss (EWL) of 41.1 ± 20.3 % where as those treated on the standard pathway (n = 61) had a mean EWL 32 ± 18.0 % (p = 0.012). CONCLUSIONS: The introduction of a pre-hospital education program has led to an improvement in attendance rates and early weight loss post-bariatric surgery.
BACKGROUND: We designed an assessment and education program which was delivered to patients prior to first outpatient appointment for bariatric surgery. We hypothesised that this program would streamline care and would lead to improved weight loss following bariatric surgery. METHODS: The program incorporates a structured general practitioners (GP) review, a patient information evening and an on-line learning package. It was introduced in September 2012. Patient flow through the program was recorded. Outcomes of the new program were compared with contemporaneously treated patients who did not undertake the pre-hospital program. RESULTS: All 636 patients on the waiting list for first appointment at the Alfred Health bariatric surgery clinic were invited to participate. There were 400 patients ultimately removed from the waiting list for first appointment. Of the remaining 236 patients, 229 consented to participate in the new program. The mean BMI was 47.8 ± 9.2. The fail to attend first appointment rate dropped from 12 to 2.1 %. At 12 months post-bariatric surgery, patients who undertook the new program (n = 82) had a mean excess weight loss (EWL) of 41.1 ± 20.3 % where as those treated on the standard pathway (n = 61) had a mean EWL 32 ± 18.0 % (p = 0.012). CONCLUSIONS: The introduction of a pre-hospital education program has led to an improvement in attendance rates and early weight loss post-bariatric surgery.
Entities:
Keywords:
Education; Health service delivery; Obesity; Preconditioning; Weight loss
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