Elsevier

Surgery for Obesity and Related Diseases

Volume 9, Issue 6, November–December 2013, Pages 956-962
Surgery for Obesity and Related Diseases

Original article
Patient predictors of follow-up care attendance in Roux-en-Y gastric bypass patients

https://doi.org/10.1016/j.soard.2012.11.005Get rights and content

Abstract

Background

Multidisciplinary care after bariatric surgery is important for long-term safety and optimal weight loss, yet many patients do not attend follow-up appointments. We sought to identify demographic, psychosocial, and weight-related variables that were associated with medical and behavioral health appointment attendance after bariatric surgery.

Methods

A retrospective chart review was conducted with consecutive patients (n=538) obtaining first-time Roux-en-Y gastric bypass surgery between August 2009 and August 2010. Demographic and psychosocial data were compared between high (>50%) and low (≤50%) medical appointment attendees and high (>50%) and low (≤50%) behavioral health group attendees in their first postoperative year. Percentage excess weight loss at 6 months after surgery was evaluated as a predictor of 12-month appointment attendance.

Results

High medical appointment attendees were more likely to be older, be Caucasian, and have lower phobic anxiety than low medical appointment attendees. High behavioral health attendees had shorter travel distance to the clinic and lower levels of hostility, anxiety, and phobic anxiety compared with low attendees. In multivariate analyses, race/ethnicity and phobic anxiety remained significant predictors of medical attendance, while travel distance to clinic predicted behavioral health attendance. Six-month percent excess weight loss predicted medical appointment attendance at 12 months.

Conclusion

The identified predictors of poor attendance at medical and behavioral bariatric surgery follow-up appointments should inform efforts to increase follow-up and improve surgical outcomes.

Section snippets

Methods

Data were collected from 538 consecutive patients undergoing a first-time LRYGB bariatric surgery at a large university medical center between August 2009 and August 2010. Data were retrieved from a secure electronic database in February 2012. Surgeries were performed by 1 of the 6 surgeons operating at this center during the study period (4 Caucasian, 2 Asian). This study was approved by the medical center’s Institutional Review Board for research on human participants.

Psychosocial and

Descriptive statistics

Average weight and BMI before surgery were 137.7 kg (SD = 26.7) and 48.5 kg/m2 (SD = 7.97), respectively. Additional descriptive data are provided in Table 1. Examination of attendance data show that 75.3% of patients were considered high medical appointment attendees and 24.7% were considered low attendees. For behavioral health appointments, 59.9% were high attendees and 40.1% were low attendees. Attendance at the 3-week, 3-month, 6-month, and 12-month medical appointments was 89.4%, 85.9%,

Discussion

The present study sought to identify factors associated with attendance at medical and behavioral health follow-up care in the first year after bariatric surgery. Among potential demographic predictors, we found that older age and Caucasian race were associated with greater attendance at medical follow-up appointments in univariate analyses. With regard to age, these results are consistent with several studies that have found that older age is related to attendance at bariatric follow-up care

Disclosures

The authors have no commercial associations that might be a conflict of interest in relation to this article.

References (25)

  • R. Burgmer et al.

    Psychological outcome two years after restrictive bariatric surgery

    Obes Surg

    (2007)
  • W.E. Encinosa et al.

    Recent improvements in bariatric surgery outcomes

    Med Care

    (2009)
  • Cited by (52)

    • Loss to follow-up after laparoscopic gastric bypass surgery – a post hoc analysis of a randomized clinical trial

      2019, Surgery for Obesity and Related Diseases
      Citation Excerpt :

      Furthermore, patients undergoing bariatric surgery do not constitute a homogenous group, and follow-up must be adapted to suit different groups of patients. Factors such as cognitive function [27] and ethnic background [9,16] may influence follow-up attendance, and follow-up may require adaptation. When asked why they do not attend, many patients state that work- and family-related issues [17], long travelling distance [16,25], impersonal follow-up programs, and unnecessary administrative barriers [28] are important factors.

    View all citing articles on Scopus

    This research was supported in part by fellowship grant T32HS000079 from the Agency for Healthcare Research and Quality. The views expressed in this article are those of theauthors and do not necessarily represent the views of the VA or the U.S. government.

    View full text