A qualitative study of the role of Australian general practitioners in the surgical management of obesity

Jose, Kim; Venn, Alison; Nelson, Mark; Howes, Faline; Wilkinson, Stephen; Ezzy, Douglas

doi:10.1111/cob.12195

Cited by 10 publications

(15 citation statements)

References 21 publications

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“…Our study confirms previous qualitative findings on the importance of continuity of care,19 the ability to access professional advice (often from the specialist dietitian) between appointments via telephone or email,31 the lack of psychological support after surgery19 28–30 32 33 36 46 and the need for moderation in patient support groups 33 34. Previous studies have related patients’ views that GPs were not equipped to adequately support them postsurgery 19 30 31 47. This was also evident in our study with most participants describing negative experiences with GPs in relation to bariatric surgery, and feeling they were unable to offer adequate support.…”

Section: Discussionsupporting

confidence: 87%

Patients’ experiences of life after bariatric surgery and follow-up care: a qualitative study

et al. 2020

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ObjectivesBariatric surgery is the most clinically effective treatment for people with severe and complex obesity, however, the psychosocial outcomes are less clear. Follow-up care after bariatric surgery is known to be important, but limited guidance exists on what this should entail, particularly related to psychological and social well-being. Patients’ perspectives are valuable to inform the design of follow-up care. This study investigated patients’ experiences of life after bariatric surgery including important aspects of follow-up care, in the long term.DesignA qualitative study using semistructured individual interviews. A constant comparative approach was used to code data and identify themes and overarching concepts.SettingBariatric surgery units of two publicly funded hospitals in the South of England.ParticipantsSeventeen adults (10 women) who underwent a primary operation for obesity (mean time since surgery 3.11 years, range 4 months to 9 years), including Roux-en-Y gastric bypass, adjustable gastric band and sleeve gastrectomy, agreed to participate in the interviews.ResultsExperiences of adapting to life following surgery were characterised by the concepts of ‘normality’ and ‘ambivalence’, while experiences of ‘abandonment’ and ‘isolation’ dominated participants’ experiences of follow-up care. Patients highlighted the need for more flexible, longer-term follow-up care that addresses social and psychological difficulties postsurgery and integrates peer support.ConclusionsThis research highlights unmet patient need for more accessible and holistic follow-up care that addresses the long-term multidimensional impact of bariatric surgery. Future research should investigate effective and acceptable follow-up care packages for patients undergoing bariatric surgery.

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Section: Discussionsupporting

confidence: 87%

Patients’ experiences of life after bariatric surgery and follow-up care: a qualitative study

et al. 2020

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“…Offering chewable or liquid form of vitamins to will also aid bariatric patients with swallowing difficulty [59] • The role of the family physician in bariatric post-surgery care is important to consider. However, the nature of their involvement post-surgery care is currently unclear [60]. Greater role clarity and enhanced collaboration between surgeons, general practitioners and patients following surgery is likely to enhance the experience and outcomes for patients and encourage and support the maintenance of postsurgical care [60].…”

Section: Preventive Strategies Of Nutritional Deficienciesmentioning

confidence: 99%

“…However, the nature of their involvement post-surgery care is currently unclear [60]. Greater role clarity and enhanced collaboration between surgeons, general practitioners and patients following surgery is likely to enhance the experience and outcomes for patients and encourage and support the maintenance of postsurgical care [60].…”

Section: Preventive Strategies Of Nutritional Deficienciesmentioning

confidence: 99%

Nutritional Deficiencies Post Bariatric Surgery: A Forgotten Area Impacting Long-Term Success and Quality of Life

Ansari¹

2021

Bariatric Surgery - From the Non-Surgical Approach to the Post-Surgery Individual Care

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Bariatric surgery (BS) results in significant weight loss and improvement of obesity associated comorbidities. Despite the benefits achieved with these operations, deficiencies of vitamins and other micronutrients are common. Such deficiencies may become clinically significant if not discovered and treated early. Therefore, it is imperative to undertake thorough screening, and have sound preventive strategies in place in order to make BS a safer procedure. This chapter will provide the multidisciplinary bariatric team with a comprehensive review of micronutrient deficiencies before and after bariatric surgery. The focus will be on the most common micronutrient deficiencies that are encountered in various types of BS procedures, including water soluble vitamins, fat-soluble vitamins, minerals and trace elements deficiencies, as well as protein malnutrition. The chapter starts with an overview of the causes of micronutrient deficiencies in patients with obesity and before undergoing BS. It reviews the screening of patients for preexisting micronutrient deficiencies prior to their BS. Then the chapter addresses the potential causes and mechanisms leading to such deficiencies after BS. It then conducts an in depth discourse of the prevalence of deficiencies by the type of BS, the presenting symptoms, and the investigations required for the diagnoses. The chapter will also discuss the management of each deficiency according to the severity of the symptoms. The chapter also reviews the recent updated guidelines for standard nutritional care post BS. We will finally conclude with a framework of the preventive strategies for optimal care to ensure long term success post-surgery.

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“…Clinicians also identified that handover to general practitioners (GPs) were difficult, as not all patients had regular GPs and not all GP practices could provide adequate support to patients. These findings are concurrent with research indicating GPs are best situated to provide long term community care for people with obesity but require additional training, support, and role clarification to achieve this [31][32][33]. This is particularly important, as it has been identified that GPsare ill equipped to manage obesity with the current level of training and tools at their disposal.…”

Section: Service-related Factors Influencing Transitionmentioning

confidence: 59%

Support needs of people living with obesity during transition from tertiary obesity treatment to community care

Alsultany

El-Masri

MacMillan

et al. 2022

Preprint

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Background: As the number of people living with obesity increases, the maintenance of treatment outcomes is especially pertinent. Treatment at tertiary obesity services have proven to be successful, but patients need to be transitioned out of these services to community-based care to accommodate the influx of new patients. Little is known about the support needs of patients after transition from acute tertiary obesity services. It is important to establish the supports needed by these patients, especially in the context of maintaining treatment outcomes and ensuring continuity of care. Methods: A qualitative study was conducted to identify the support needs of people with obesity as they transition to community care. Patients and clinicians recruited from a tertiary obesity clinic participated in semi-structured interviews and focus groups to explore factors influencing transition and supports needed in the community. Data was collected through audio recordings, transcribed verbatim and analysed thematically. Results: A total of 16 patients and 7 clinicians involved in the care of these patients participated between July 2020 and July 2021. Themes identified included the influence of clinic and individual factors on transition, the benefits of phased transition, patient-centred communication, and the role of social support. It was found that dependency and lack of self-efficacy, as well as low social support, hindered transition efforts. It was also identified that patients required substantial integrated professional and social support structures in the community to adequately address their care needs both during and following transition. Conclusion: Interventions are needed to provide social community services following transition to ensure adequate community care that can support the maintenance of treatment outcomes. Such services should be integrated and address the social needs of people living with obesity.

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A qualitative study of the role of Australian general practitioners in the surgical management of obesity

Cited by 10 publications

References 21 publications

Patients’ experiences of life after bariatric surgery and follow-up care: a qualitative study

Patients’ experiences of life after bariatric surgery and follow-up care: a qualitative study

Nutritional Deficiencies Post Bariatric Surgery: A Forgotten Area Impacting Long-Term Success and Quality of Life

Support needs of people living with obesity during transition from tertiary obesity treatment to community care

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