Elsevier

Surgery for Obesity and Related Diseases

Volume 6, Issue 6, November–December 2010, Pages 597-600
Surgery for Obesity and Related Diseases

Original article
Travel distance as factor in follow-up visit compliance in postlaparoscopic adjustable gastric banding population

https://doi.org/10.1016/j.soard.2010.09.008Get rights and content

Abstract

Background

Despite the 2008 “American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic and Bariatric Surgery Medical Guidelines for Clinical Practice for the Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery Patient,” consensus does not exist for postoperative care in laparoscopic adjustable gastric banding (LAGB) patients (grade D evidence). It has been suggested that regular follow-up is related to better outcomes, specifically greater weight loss. The aim of the present study was to investigate the effects of travel distance to the clinic on the adherence to follow-up visits and weight loss in a cohort of LAGB patients in the setting of a rural, university-affiliated teaching hospital in the United States.

Methods

A retrospective chart review was performed of all consecutive LAGB patients for a 1-year period. Linear regression analysis was used to identify the relationships between appointment compliance and the distance traveled and between the amount of weight loss and the distance traveled.

Results

Linear regression analysis was performed to investigate the effect of the travel distance to the clinic on the percentage of follow-up visits postoperatively. This effect was not significant (P = .4). Linear regression analysis was also performed to elucidate the effect of the travel distance to the clinic on the amount of weight loss. This effect was significant (P = .04).

Conclusion

The travel distance to the clinic did not seem to be a significant predictor of compliance in a cohort of LAGB patients with ≤1 year of follow-up in a rural setting. However, a weak relationship was found between the travel distance to the clinic and weight loss, with patients who traveled further seeming to lose slightly more weight.

Section snippets

Methods

In the present study, the data from all consecutive patients undergoing LAGB (LAP-BAND, Allergan, Irvine, CA) at Fletcher Allen Healthcare (FAHC) from November 2008 to November 2009 were prospectively entered into an electronic database. Of the 116 LAP-BANDs, 58 were the AP model and 58 were the 10-cm model. All procedures were performed by a single surgeon (P.M.F.). The patients' follow-up data were cross-referenced using their home zip code. The travel distance from their home to our clinic

Results

Table 1 lists the characteristics of the 116 patients in the cohort at baseline. Of the 116 patients, 94% were women. The average age of all patients was 46.1 years. The average initial body weight was 237.3 lb. The average body mass index was 40.2 kg/m2. The average travel distance to the clinic was 39.5 miles.

At 1 year, the average body weight was 206.2 lb. The percentage of excess weight loss was 26.6% (range −4% to 61%). The average overall follow-up attendance rate was 68%. The follow-up

Discussion

The FAHC is a university-based, 562-bed, teaching hospital serving the entire state of Vermont and northeastern New York state. FAHC offers the only minimally invasive bariatric surgery program within a 90-mile radius.

To our knowledge, this is the first study to examine the question of whether the travel distance to the clinic affects follow-up appointment adherence and weight loss after LAGB. Our finding that the travel distance to the clinic in the postoperative period was not a significant

Conclusion

Many factors will determine patient compliance with postoperative follow-up after LAGB. However, the travel distance to the clinic did not seem to be a significant predictor of this in a cohort of patients in a rural setting. However, a weak relationship was found between the travel distance to the clinic and weight loss, with the patients who traveled farther seeming to lose slightly more weight.

References (6)

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