Community-Based Bariatric Surgical Follow-Up Service: Perspectives and Needs

Developing a long-term, community-based bariatric
Developing a long-term, community-based bariatric
surgical follow-up service: patient and professional
surgical follow-up service: patient and professional
perspectives
perspectives
Professor Yitka Graham
 
Head of the Helen McArdle Nursing and Care Research Institute and Professor of Health Services Research, University of
Sunderland, UK
Chair, Professional Guidelines Committee, IFSO Integrated Health Chapter
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I have the following potential conflict(s) of interest to report:
 
Receipt of grants/research supports:
Celebrate Nutritional Supplements
Molylncke
Receipt of honoraria or consultation fees:
Olympus Medical
Participation in a company sponsored speaker’s bureau:
Intuitive
Olympus Medical
 
 
Aim of presentation:
To understand the needs of patients and professionals  when
developing a long-term community-based follow-up service or
bariatric surgical patients
 
 
Background:
In the UK, bariatric surgical patients are discharged from hospital into the
community following two years of follow up₁
NICE guidance for annual monitoring is ambiguous in terms of the role of
General Practice₁
Published recommendations are not well known in General Practice
Paucity of research on what is needed/wanted and resources available in the
community from the perspectives of General Practice and patients
Little collaborative research with the community in bariatric surgery
Co-design means both parties have ownership and can actively participate
from design to dissemination
National Institute for Health and Care Execellence (2014)Obesity: identification, assessment and management (CG189) London: NICE
 
 
Methods:
Patient participants were recruited from bariatric surgical clinic lists at STSFT
Time from surgery anywhere from 7 months  – 8 years
Healthcare professionals were recruited through snowball and purposive sampling
Data was collected through video and telephone interviews June – October 2021
Data was transcribed verbatim and analysed using a thematic analytic framework₂
A social constructivist theoretical lens was used
asserts that
 reality is shaped through interactions with others and influenced by life
experiences, social norms and values₃
This perspective aids understanding of participants’ role and further illuminates
findings
 
 
Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology. 2006;2(2):77-101
Conrad P, Barker KK. The Social Construction of Illness: Key Insights and Policy Implications. Journal of Health and Social Behavior. 2010;51(1 suppl):S67-S79.
 
 
Results:
Patient participant demographics:
14 patient participants 
(11 female, 3 male )
Mean age = 51 years 
(30 – 70 years old)
Mean time since surgery = 
3.9 years (7 months –
8 years)
Ethnicity: 
all participants stated ethnicity as
White
Procedures: 13 Roux-en-Y bypass, 1 OAGB
All were primary procedures
 
 
 
Results:
Professional participant demographics
16 professionals (11 female, 5 male)
General Practitioners = 5
4 General Practitioners
1 General Practitioner/Commissioner
Practice Nurses = 4
Pharmacists = 7
Ethnicity: White = 9 Asian = 3,Black = 2
 
Emergent themes - patients
 
Needing formal longer-term support
Compliance
Slipping back into old habits
More psychological support needed
Dealing with aspects of life after
surgery
No formal psychological support
Dealing with weight gain
Issues pertaining to the pandemic
 
Themes: patient participants
 
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s
 
Unsure of what is needed to support patients
Lack of understanding about bariatric
procedures
No formal learning about bariatric surgery
(CPD,curriculum)
Little knowledge is self-taught
Communication from bariatric unit is unclear
and ambiguous
Patients sometimes know more than the
professional
Medication issues
 
 
 
 
Themes: professional participants
 
 
Community Pharmacists  and Practice Nurses were enthusiastic
about:
The topic of bariatric surgery
Becoming more involved in long-term follow up and support of
bariatric patients
GPs had a variety of attitudes towards bariatric surgery
Involvement of commissioners was crucial to recruitment and data
collection
Changes to national NHS commissioning has delayed nest steps
but discussions still taking place
 
 
 
 
Discussion:
 
Reflections on the process
 
Multiple
perspectives aids
understanding
 
Conclusions
 
More research needed in collaboration with the community and patients
General Practice environment challenging, but rewarding
Relationships established that will continue after this study
Pandemic has impacted patients’ journeys
Further, more formal long-term support needed
Psychological support needs embedding in follow-up
Community healthcare professionals knowledge levels of bariatric surgery are
low
Opportunities for all healthcare professionals in the community to support
patients
Multidisciplinary approach in the community needed
 
 
Conclusions
 
Aims of
presentation
 
Thank you to my collaborators:
Ann Fox
Kamal Mahawar
Julie Parrott
Fadi Khalil
Catherine Hayes
Follow me @ProfessorYitka
 
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This research by Professor Yitka Graham explores the perspectives of patients and healthcare professionals on establishing a community-based bariatric surgical follow-up service. The study aims to understand the requirements for long-term care post-surgery, highlighting the lack of clarity in current guidelines and the limited research on community resources. Utilizing a social constructivist approach, the project delves into the interactions and experiences that shape patient and professional roles in bariatric care.

  • Bariatric Surgery
  • Community Health
  • Long-Term Care
  • Patient Perspectives
  • Healthcare Professionals

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  1. Developing a long-term, community-based bariatric surgical follow-up service: patient and professional perspectives Professor Yitka Graham Head of the Helen McArdle Nursing and Care Research Institute and Professor of Health Services Research, University of Sunderland, UK Chair, Professional Guidelines Committee, IFSO Integrated Health Chapter

  2. CONFLICT OF INTEREST DISCLOSURE CONFLICT OF INTEREST DISCLOSURE I have the following potential conflict(s) of interest to report: Receipt of grants/research supports: Celebrate Nutritional Supplements Molylncke Receipt of honoraria or consultation fees: Olympus Medical Participation in a company sponsored speaker s bureau: Intuitive Olympus Medical

  3. Aim of presentation: To understand the needs of patients and professionals when developing a long-term community-based follow-up service or bariatric surgical patients

  4. Background: In the UK, bariatric surgical patients are discharged from hospital into the community following two years of follow up NICE guidance for annual monitoring is ambiguous in terms of the role of General Practice Published recommendations are not well known in General Practice Paucity of research on what is needed/wanted and resources available in the community from the perspectives of General Practice and patients Little collaborative research with the community in bariatric surgery Co-design means both parties have ownership and can actively participate from design to dissemination National Institute for Health and Care Execellence (2014)Obesity: identification, assessment and management (CG189) London: NICE

  5. Methods: Patient participants were recruited from bariatric surgical clinic lists at STSFT Time from surgery anywhere from 7 months 8 years Healthcare professionals were recruited through snowball and purposive sampling Data was collected through video and telephone interviews June October 2021 Data was transcribed verbatim and analysed using a thematic analytic framework A social constructivist theoretical lens was used asserts that reality is shaped through interactions with others and influenced by life experiences, social norms and values This perspective aids understanding of participants role and further illuminates findings Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology. 2006;2(2):77-101 Conrad P, Barker KK. The Social Construction of Illness: Key Insights and Policy Implications. Journal of Health and Social Behavior. 2010;51(1 suppl):S67-S79.

  6. Results: Patient participant demographics: 14 patient participants (11 female, 3 male ) Mean age = 51 years (30 70 years old) Mean time since surgery = 3.9 years (7 months 8 years) Ethnicity: all participants stated ethnicity as White Procedures: 13 Roux-en-Y bypass, 1 OAGB All were primary procedures

  7. Results: Professional participant demographics 16 professionals (11 female, 5 male) General Practitioners = 5 4 General Practitioners 1 General Practitioner/Commissioner Practice Nurses = 4 Pharmacists = 7 Ethnicity: White = 9 Asian = 3,Black = 2

  8. Emergent themes - patients Themes: patient participants Needing formal longer-term support Compliance Slipping back into old habits More psychological support needed Dealing with aspects of life after surgery No formal psychological support Dealing with weight gain Issues pertaining to the pandemic

  9. Eprofessionals Eprofessionals Themes: professional participants Unsure of what is needed to support patients Lack of understanding about bariatric procedures No formal learning about bariatric surgery (CPD,curriculum) Little knowledge is self-taught Communication from bariatric unit is unclear and ambiguous Patients sometimes know more than the professional Medication issues

  10. Discussion: Community Pharmacists and Practice Nurses were enthusiastic about: The topic of bariatric surgery Becoming more involved in long-term follow up and support of bariatric patients GPs had a variety of attitudes towards bariatric surgery Involvement of commissioners was crucial to recruitment and data collection Changes to national NHS commissioning has delayed nest steps but discussions still taking place

  11. Reflections on the process Professionals were difficult to recruit Time pressures Study was co-designed with commissioners, General Practice and patients Patients were keen to participate Able to recruit 13 participants 2 >years post surgery Perceived indifference to bariatric surgery Far more straightforward in terms of recruitment Illuminated the longer-term experience of follow-up in the community Needed to ensure we had a good cross section of attitudes towards bariatric surgery Multiple perspectives aids understanding Participants sent study information to colleagues to try and address this

  12. Conclusions Conclusions More research needed in collaboration with the community and patients General Practice environment challenging, but rewarding Relationships established that will continue after this study Pandemic has impacted patients journeys Further, more formal long-term support needed Psychological support needs embedding in follow-up Community healthcare professionals knowledge levels of bariatric surgery are low Opportunities for all healthcare professionals in the community to support patients Multidisciplinary approach in the community needed

  13. Aims of presentation Ann Fox Kamal Mahawar Julie Parrott Fadi Khalil Catherine Hayes Follow me @ProfessorYitka Thank you to my collaborators:

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