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A randomized clinical trial evaluating eHealth in bariatric surgery

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Abstract

Background

Supporting patients before, and long after, their bariatric treatment contributes a lot to successful outcome. eHealth interventions have a hypothetical benefit in addition to standard care. This could lead to increased weight loss, reduction of obesity-related diseases, patient adherence, and quality of life. This randomized controlled trial aims to evaluate the value of an eHealth platform and self-monitoring devices as additions to standard bariatric care.

Materials and methods

Two-hundred-and-five patients who underwent primary bariatric surgery were randomized (2:1:1) to receive standard care (control group), additional access to an educational patient eHealth platform (online group), or additional access to eHealth platform as well as self-monitoring devices (device group). The platform consisted of an interactive educational environment with informational videos, dietary advice, news, and more. The self-monitoring devices used were a weight scale, blood pressure monitor, pulse oximeter, and activity bracelet. The primary endpoint was weight loss and secondary outcomes included reduction of obesity-related diseases, quality of life, and eHealth use.

Results

Postoperative weight loss, reduction of obesity-related diseases, frequency of consultations, and quality of life were similar between groups. Participation to the eHealth platform was high (online group 90%, device group 98%). Most frequently accessed contents were informational messages, videos, and the treatment preparation modules. The percentage of active users of the self-monitoring devices dropped from 62% in the first postoperative month to 19% after 2 years. Thirteen patients in the device group withdrew due to unwillingness to use self-monitoring devices.

Conclusion

Participation to the eHealth intervention in addition to the standard post-bariatric guidance program was high, however, had no significant impact on clinical outcomes such as weight loss, reduction of obesity-related diseases, and quality of life.

Trial registration ClinicalTrials.gov (identifier number NL56992.100.16) https://clinicaltrials.gov/ct2/show/NCT03394638

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Authors and Affiliations

  1. Department of Surgery, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands

    Dirk P. A. Versteegden, Magaly J. J. Van Himbeeck, Misha D. Luyer, Gust van Montfort, Jean-Paul J. G. M. de Zoete, Johannes Franciscus Smulders & Simon W. Nienhuijs

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  1. Dirk P. A. Versteegden
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  2. Magaly J. J. Van Himbeeck
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  3. Misha D. Luyer
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  4. Gust van Montfort
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  7. Simon W. Nienhuijs
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Corresponding author

Correspondence to Dirk P. A. Versteegden.

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Disclosures

The bariatric department received an educational grant from Medtronic. Mr. Dirk Versteegden, Ms. Magaly Van himbeeck, Dr. Misha Luyer, Mr. Gust van Montfort, Mr. Jean-Paul de Zoete, Mr. J. Frans Smulders and Dr. Simon Nienhuijs have no other conflict of interest to report.

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Versteegden, D.P.A., Van Himbeeck, M.J.J., Luyer, M.D. et al. A randomized clinical trial evaluating eHealth in bariatric surgery. Surg Endosc 37, 7625–7633 (2023). https://doi.org/10.1007/s00464-023-10211-w

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