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Changing Knowledge and Attitudes towards Bariatric Surgery in Primary Care: a 10-Year Cross-Sectional Survey

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Abstract

Background

Some 28% of the Scottish population suffer from obesity. Bariatric procedures per population carried out in England when compared to Scotland (NBSR 2018) are significantly higher. Primary care practitioners (PCP) influence equality of access to secondary care bariatrics and frequently manage post-operative bariatric patients. Examining changes in PCP knowledge and attitude could improve access to bariatric procedures in Scotland.

Methods

Following a sample pilot, all PCPs within three Scottish NHS health boards were emailed a questionnaire-based survey (2011; n = 902). A subsequent 10-year follow-up encompassed a greater scope of practice, additionally distributed to all PCPs in five further health boards (2021; n = 2049).

Results

Some 452 responses were achieved (2011, 230; 2021, 222). PCPs felt bariatric surgery offered a greater impact in both weight management and that of obesity-related diseases (p < .0001). More PCPs were aware of local bariatric surgical referral criteria (2011, 43%; 2021, 57% (p = .003)), and more made referrals (2011, 60%; 2021, 72% (p = .018)) but were less familiar with national bariatric surgical guidelines (2011, 70%; 2021, 48% (p < .001)). Comfort at managing post-operative bariatric surgical patients were unchanged (2011, 24%; 2021, 27% (p = .660)). Minimal progress through dietetic-lead weight management services, plus rejection of patients thought to be good candidates, was reasons for referral hesitancy.

Conclusion

Over 10 years, PCPs were more aware of local referral criteria, making increased numbers of referrals. Knowledge deficits of national guidelines remain, and overwhelmingly PCPs do not feel comfortable looking after post-operative bariatric surgical patients. Further research into PCP educational needs, in addition to improving the primary to secondary care interface, is required.

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Data Availability

Informed consent was obtained from all individuals completing the questionnaire. Data can be obtained upon request from authors.

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Authors and Affiliations

  1. Forth Valley Royal Hospital, Larbert, FK5 4WR, Scotland, UK

    Benjamin Douglass, Ben Parkin, Michael Wilson & James Kynaston

  2. University Hospital Wishaw, Lanark, ML2 0DP, Scotland, UK

    Sheibon Hassakama Lau

  3. Glasgow, UK

    Sheibon Hassakama Lau

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  1. Benjamin Douglass
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  3. Ben Parkin
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  4. Michael Wilson
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Corresponding author

Correspondence to Sheibon Hassakama Lau.

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Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Key points

1. Investigating understanding of PCPs in Scotland towards bariatric surgery.

2. Overall, greater appreciation of operative weight loss surgery is achieved.

3. Demonstrable dissatisfaction of tier 3 weight loss services by PCPs.

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Douglass, B., Lau, S.H., Parkin, B. et al. Changing Knowledge and Attitudes towards Bariatric Surgery in Primary Care: a 10-Year Cross-Sectional Survey. OBES SURG 34, 71–76 (2024). https://doi.org/10.1007/s11695-023-06934-3

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