Emily C Benham, MD, Anahita Jalilvand, MD, Kelsey Russell, RDN, LD, Adam Freter, RDN, LD, Bradley Needleman, MD, Sabrena Noria, MD, PhD. The Ohio State University, Wexner Medical Center
Objectives: Successful outcomes after bariatric surgery (BS) require a comprehensive educational program (CEP) focused on post-surgical dietary and lifestyle changes. At our institution, patients must comply with a 4-week Life-After-Surgery program prior to surgery. Since many patients are not able to participate in-person, an online CEP was created to improve accessibility. To evaluate comprehension, a 16-question test is administered at the last preoperative visit to participants of both classes. The primary objective of this study is to evaluate the effectiveness of online versus in-person CEP in terms of comprehension and post-operative weight loss.
Methods: Patients who underwent BS from August 2016-May 2017 were retrospectively reviewed at a single institution. All patients who underwent the in-person or online CEP, completed the 16-question test, and had post-operative follow-up for at least 6 months were included. Baseline demographic, operative, and weight data were obtained using the electronic medical record. Percent excess body weight-loss (EBWL) was determined for patients at 2, 8 and 24 weeks after surgery. Student’s t-test, Mann-Whitney U, Chi squared, and Fisher’s Exact tests were utilized to calculate significance. Independent predictors of EBWL were determined using multiple linear regression. A p-value of <0.05 was considered significant.
Results: A total of 95 patients participated in the online (51.58%) or in-person (48.42%) CEP, of which 81% were female, the mean age was 45.2 ± 11.4 years, and the mean pre-operative BMI was 49.8 ± 8.2 kg/m2. Most had private insurance (77%), while the remainder had Medicaid/Medicare (23%). Although test scores did not differ between the online and in-person courses (78.3% vs 78.6%, p=0.9041), scores were higher for patients who took the test < 2 months after course completion (81% vs 75%, P=0.019) and had private insurance (81% vs 75%, P=0.0128). While test scores did not correlate with EBWL at any post-operative time point, significant independent predictors of EBWL at 2-weeks included the in-person CEP (p=0.035) and male gender (p=0.036).
Conclusion: The results demonstrate that test scores did not differ by course type and did not correlate to post-operative EBWL. However, in-person CEP was an independent predictor of improved EBWL at 2 weeks, suggesting an advantage over online courses not captured by the test scores. The difference in scores by insurance status further underscores the importance of optimizing the method of evaluating comprehension. Future studies are required to investigate the effectiveness of these different modalities.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86479
Program Number: P573
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster