Remote Follow-up with a Mobile Application Is Equal to Traditional Outpatient Follow-up After Bariatric Surgery: the BELLA Pilot Trial

Abstract

Purpose Medical follow-up after bariatric surgery is recommended. However, the compliance was poor. This study aimed to evaluate the feasibility of a smartphone-based fully remote follow-up (FU) program for patients after bariatric surgery. Methods In the interventional group, patients were followed up using a smartphone application (app), through which questionnaires were sent regularly. Participants in the control group underwent standard FU at the outpatient clinic every three months. After 12 months, all the participants were evaluated at an outpatient clinic. Results Between August 2020 and March 2021, 44 and 43 patients in the interventional and control groups, respectively, were included in the analysis after three patients were lost to FU, and three withdrew their informed consent because they wished for more personal contact with medical caregivers. After 12 months, total weight loss (TWL), %TWL, and percentage of excess weight loss (%EWL) did not differ between groups. There were no significant differences in the complication rates, including surgical complications, malnutrition, and micronutrition deficiency. The parameters of bioelectrical impedance analysis and quality of life did not differ between the groups. Vitamins and minerals in serum were similar in both groups except for calcium, which was significantly higher in the interventional group (2.52 mmol/L vs. 2.35 mmol/L, p = 0.038). Conclusion Fully remote FU with a smartphone application is at least as effective as traditional in-person FU in an outpatient clinic after bariatric surgery. Through remote FU, patients can save time and medical professionals may have more resources for patients with more severe problems. Graphical Abstract

Intervención y seguimiento a largo plazo en cirugía bariátrica. Impacto en los resultados de pérdida ponderal y calidad de vida en pacientes con obesidad.

“…En los últimos años, y aún más tras el confinamiento sufrido, se han implementado nuevas tecnologías y aplicaciones móviles para el seguimiento de los pacientes tras la cirugía bariátrica, con resultados prometedores, ya que presentan una gran aceptación por parte de los pacientes por sus ventajas (ahorro de tiempo, beneficios relacionados con el trabajo/ocupación, relevancia similar a la consulta tradicional,…), lo que a su vez se traduce en muy buenas tasas de seguimiento, si bien un 30% preferían el formato tradicional 138,139 .…”