RT Journal Article
SR Electronic
T1 Post-bariatric surgery nutritional follow-up in primary care: a population-based cohort study
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP bjgp20X714161
DO 10.3399/bjgp20X714161
A1 Helen Parretti
A1 Anuradhaa Subramanian
A1 Nicola Adderley
A1 Abbott Sally
A1 Tahrani Abd
A1 Krishnarajah Nirantharakumar
YR 2020
UL http://bjgp.org/content/early/2020/12/09/bjgp20X714161.abstract
AB Abstract Background: Bariatric surgery is the most effective treatment for severe obesity. However, without recommended follow-up it has long-term risks. Aim: To investigate whether nutritional and weight monitoring in primary care meets current clinical guidance, post-specialist discharge. Design and setting: Retrospective cohort study. Primary care practices contributing to IQVIA Medical Research Data (IMRD)–UK (1/1/2000-17/1/2018). Methods: Participants were adults who had had bariatric surgery with a minimum of three years’ follow-up post-surgery as this study focused on patients discharged from specialist care (at 2yrs post-surgery). Outcomes were annual proportion of patients from 2yrs post-surgery with a record of recommended nutritional screening blood tests, weight measurement and prescription of nutritional supplements, and proportions with nutritional deficiencies based on blood tests. Results: 3137 participants were included and median follow-up post-surgery was 5.7 (4.2-7.6) years. 45-59% had an annual weight measurement. The greatest proportions of patients with a record of annual nutritional blood tests were for tests routinely conducted in primary care, e.g. recorded haemoglobin measurement varied between 44.9% (n=629/1400) and 61.2% (n=653/1067). Annual proportions of blood tests specific to bariatric surgery were low, e.g. recorded copper measurement varied between 1.2% (n=10/818) and 1.5% (n=16/1067) (where recommended). Results indicated that the most common deficiency was anemia. Annual proportions of patients with prescriptions for recommended nutritional supplements were low. Conclusions: Our study suggests that bariatric surgery patients are not receiving recommended nutritional monitoring post-specialist discharge. GPs and patients should be supported to engage with follow-up care. Future research should aim to understand reasons underpinning our findings.