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Compliance and Patients’ Perspectives Towards Nutritional Supplementation Following Bariatric Surgery

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Abstract

Background

Nutritional supplementation is recommended as a prophylactic strategy for nutritional deficiencies after bariatric surgery. Little is known regarding compliance and patients’ perspectives. The purpose of the study was to explore supplement intake, compliance, and patients’ perspectives (including barriers, facilitators, and beliefs) and to examine whether compliance to nutritional supplementation can be predicted after bariatric surgery.

Material and Methods

A questionnaire was developed to explore supplement intake and patients’ perspectives. The Probabilistic Medication Compliance Scale (ProMAS) was included and modified to measure behaviors related to supplementation compliance. Content validity was assessed with an expert and patient panel. Consequently, a cross-sectional survey was conducted among patients that underwent bariatric surgery, who were invited using social media. Descriptive statistics and Spearman correlations were applied. Multiple linear regression analysis was performed to predict compliance.

Results

A 58-item questionnaire was developed and content validated, resulting in a scale-content validity index of 0.93. The questionnaire was completed by 402 subjects. Sixty-nine subjects reported not consuming any nutritional supplement (n = 69; 17.2%). For the supplement users (n = 333; 82.8%), a median ProMAS sum score of 11.0 (7.0–15.0) was observed. Increasing age and medicine intake were positive predictors of compliance (age: B = 0.058, p = 0.01; medicine intake: B = 0.39, p < 0.001), while experiencing barriers was identified as a negative predictor of compliance (B =  − 4.637, p < 0.001). Top three barriers for supplement use were forgetfulness (n = 118; 29.4%), too expensive (n = 91; 22.6%), and experiencing side effects (n = 61; 15.2%).

Conclusion

Lifelong nutritional supplementation is essential after bariatric surgery, but compliance can be affected by the presence of barriers.

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Acknowledgements

We would like to thank all experts that participated in the process of developing the questionnaire.

Author information

Authors and Affiliations

  1. Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium

    Steenackers N, Vandewynckel S, Boedt T, Mertens A, Vangoitsenhoven R, Van der Schueren B & Matthys C

  2. Department of Abdominal Surgery, University Hospitals Leuven, Leuven, Belgium

    Deleus E & Lannoo M

  3. Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium

    Deleus E, Hoekx S, Lannoo M, Mertens A, Vangoitsenhoven R, Van der Schueren B & Matthys C

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  1. Steenackers N
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  10. Matthys C
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Correspondence to Matthys C.

Ethics declarations

Ethics Approval and Consent to Participate

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The research has been evaluated and approved by Education-Support Committee (MP014674). Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Key Points

1. Nutritional supplementation compliance is low with 17.2% not consuming supplements.

2. Increasing age, increasing medicine intake and experiencing barriers predict compliance.

3. Top three reported barriers are forgetfulness, too expensive and side effects.

4. Health care professionals, systems and researchers should address barriers and side effects.

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N, S., S, V., T, B. et al. Compliance and Patients’ Perspectives Towards Nutritional Supplementation Following Bariatric Surgery. OBES SURG 32, 1804–1813 (2022). https://doi.org/10.1007/s11695-022-06047-3

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  • DOI: https://doi.org/10.1007/s11695-022-06047-3

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