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Barriers to compliance with long-term follow-up after bariatric surgery.

David Radvinsky, MD, Mazen Iskander, MD, George Ferzli, MD, FACS. NYU Lutheran

Introduction: The aim of this review was to evaluate and compare our 6-month and 1-year follow-up data as a MBSAQIP Accredited Bariatric Surgery Center and address any potential barriers to patient compliance. Our goal is to find a potential target for intervention to meet the current standards set by the MBSAQIP and ultimately improve long-term weight loss for our patients.

Methods and Procedures: In this retrospective chart review follow-up data at 1-year was evaluated for 64 cases from one bariatric surgeon between January 2015 and July 2015 and 6-month data for 69 patients between September 2015 and January 2016. Patients who did not follow-up (with a member of the bariatric team) at the 1-year and 6-month mark respectively were telephoned and interviewed about barriers to compliance with follow-up.

Results: Sixty-four patients underwent bariatric surgery between January and July 2015. At 1-year, 28/64 (43.75%) of patients met the requirements for follow-up with a member of the bariatric team. Of the 36/64 patients who failed to comply, or considered lost to follow-up, 17/64 (26.5%) patients attested that they knew about the 1-year follow-up, but that they were “too busy” to make an appointment. Twelve (18.75%) patients had moved or their telephone numbers were no longer in service. Five (7.8%) patients had issues with insurance that prevented them from complying with follow-up, but stated that they knew they had to follow-up. Two (3.1%) patients stated that they were unaware of the need for follow-up. In the 6-month group, 43/69 (62.3%) of patients were compliant with follow-up, whereas 22/69 (31.9%) of patients were “too busy” or “forgot” to follow-up. Only one patient (1.44%) had an insurance issue, and one patient (1.44%) did not follow up because of issues with the staff. Two patients had moved or their telephone numbers were not in service.

Conclusions: In our retrospective review our follow-ups dropped from 62.3% of patients at 6-months to 43.75% at 1 year. The majority of patients were “too busy” or “forgot” to make an appointment. Interestingly, without prompt, these patients understood the importance of compliance, and the interview served as a reminder to make an appointment for follow-up. These results provide some answer to poor compliance and areas where a directed intervention could improve long-term follow-up. Further investigation into earlier follow-up will help identify additional patients who are lost to follow-up in the early post-operative period and help improve long-term patient compliance.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 77957

Program Number: P567

Presentation Session: Poster (Non CME)

Presentation Type: Poster

385

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