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Barriers in the Approach of Obese Patients Undergoing Bariatric Surgery in Flemish Hospitals

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Abstract

Background

Bariatric surgery is associated not only with weight loss and improvement of comorbidities of obesity but also with short and long-term complications. Preoperative screening and lifelong follow-up of these patients are important to optimize the effect of bariatric surgery and minimize complications. The objective of this study was to create an inventory of the current care offered to bariatric patients before and after surgery in Flemish hospitals, Belgium and to identify barriers for optimal care.

Methods

Semi-structured interviews with healthcare professionals involved in screening and follow-up of bariatric patients in 12 hospitals in Flanders, Belgium were performed. Interviews were transcribed verbatim and analyzed with NVivo 10.0.

Results

In each participating hospital, except one, biochemical screening before and after bariatric surgery was performed, but the extent and timing varied between hospitals. In ten hospitals, a standard multivitamin preparation was started in all patients after surgery, but there was a large variation for timing of initiation and duration between hospitals. The interviewees indicated that the knowledge about appropriate dosage and formulation adjustments after surgery was limited. Most of the performed drug adjustments were due to improvement of comorbidities. In 9 out of 12 hospitals, a multidisciplinary team was involved, but the approach varied widely. Only in 3 out of 12 hospitals, eligibility of patients for bariatric surgery was discussed in team meetings.

Conclusions

Strategies to implement existing guidelines are required in order to obtain more uniform, interdisciplinary support for bariatric patients, resulting in an increase of efficiency of surgery and improved patient care.

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Acknowledgments

A special thanks to Patricia Bosmans, Virginie Cruyt, Evelien Van Dijck, and Stephanie Vrancken for their contribution to this paper, for their efforts, their dedication, and their work and Margot Kennis for the translation of the quotes. Ina Gesquiere receives a PhD scholarship from the Agency for Innovation by Science and Technology, Flanders, IWT-111328. The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, O&N2, Herestraat 49, Box 521, 3000, Leuven, Belgium

    Ina Gesquiere & Veerle Foulon

  2. Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, O&N2, Herestraat 49, Box 921, 3000, Leuven, Belgium

    Patrick Augustijns

  3. Department of Abdominal Surgery, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium

    Matthias Lannoo

  4. Clinical and Experimental Endocrinology, KU Leuven, O&N 1, Herestraat 49, Box 902, 3000, Leuven, Belgium

    Christophe Matthys & Bart Van der Schueren

  5. Department of Endocrinology, University Hospitals Leuven, Leuven, Campus Gasthuisberg, Herestraat 49, Box 7003, 3000, Leuven, Belgium

    Christophe Matthys & Bart Van der Schueren

Authors
  1. Ina Gesquiere
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  2. Patrick Augustijns
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  3. Matthias Lannoo
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  4. Christophe Matthys
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  5. Bart Van der Schueren
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  6. Veerle Foulon
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Correspondence to Ina Gesquiere.

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Gesquiere, I., Augustijns, P., Lannoo, M. et al. Barriers in the Approach of Obese Patients Undergoing Bariatric Surgery in Flemish Hospitals. OBES SURG 25, 2153–2158 (2015). https://doi.org/10.1007/s11695-015-1680-0

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