Preoperative predictors of adherence to multidisciplinary follow-up care postbariatric surgery
Abstract
Background Long-term multidisciplinary care after bariatric surgery is important for weight maintenance and management of co-morbidities. Despite this, the rate of attendance to follow-up appointments is universally low.Objective To identify patient factors that contribute to adherence to follow-up care after bariatric surgery.Setting Three university-affiliated hospitals in Canada Methods A cohort study of 388 patients who underwent bariatric surgery from January 2011 to December 2011 was performed. This program mandates multidisciplinary follow-up care at 3, 6, and 12 months, and annually thereafter. Patients' socioeconomic, psychosocial, and medical and psychiatric co-morbidities were recorded prospectively. Adherence to follow-up care was defined as having attended the majority of clinic visits (3 or 4 out of 4); all other patients were considered nonadherent.Results The mean age of patients was 45.0 years, 81.2% were female, and the majority underwent a gastric bypass (91.8%) versus a sleeve gastrectomy (8.2%); 62.1% of patients were adherent to follow-up appointments. Patients older than 25 years had a higher adherence rate than those who were younger (63.2% versus 37.5%, P = .040). Patients with full-time or part-time employment had a significantly higher adherence rate than those who were unemployed or retired (65.6% versus 50.0%, P = .017, odds ratio 1.9). Patients with obstructive sleep apnea (OSA) before surgery had higher follow-up adherence than those without OSA (62.2% versus 37.8%, P = .044). In multivariate analysis, employment remained an independent predictor of follow-up adherence (P = .017).Conclusion Employment was the strongest predictor of attendance to follow-up clinic. Patients with OSA and older patients were also more likely to return consistently for scheduled follow-up.
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Pre-operative psychiatric diagnoses were not predictive of follow-up appointment attendance.
“pre‐operative psychiatric diagnoses, 15 , 16 and psychiatric “stability” (i.e., having either no psychiatric history or well‐managed symptoms) 17 were not predictive of follow‐up appointment attendance.”
From Psychological predictors of adherence to lifestyle changes after bariatric surgery: A systematic review (2024) · cites this paper as [15]
There was no significant link between adherence and generalized anxiety in other studies.
“However, there was no significant link between adherence and generalized anxiety 15 , 20 or an anxious attachment style 21 in other studies.”
From Psychological predictors of adherence to lifestyle changes after bariatric surgery: A systematic review (2024) · cites this paper as [15]
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Kedestig, J., & Stenberg, E. (2019) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2019.03.010 · Cited by 23 · see citing works
Chan, J. K. Y., & Vartanian, L. R. (2024) · Obesity Science & Practice · doi:10.1002/osp4.741 · Cited by 22 · see citing works
“21 However, there was no significant link between adherence and generalized anxiety 15,20 or an anxious attachment style 21 in other studies.”
BackgroundMethodChang, S.-H., Gasoyan, H., Wang, M., Ackermann, N., Liu, X., Herrick, C., Eckhouse, S., Dimou, F., Vuong, L., Colditz, G. A., et al. (2022) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2021.11.017 · Cited by 9 · see citing works
- Authors
- Larjani, S., Spivak, I., Hao Guo, M., Aliarzadeh, B., Wang, W., Robinson, S., Sockalingam, S., & Aarts, M.-A.
- Affiliations
- University of Toronto (CA)
- University Health Network (CA)
- Corresponding author
- Aarts, Mary-Anne
- Venue
- Surgery for Obesity and Related Diseases
- Publisher
- Elsevier BV
- Published
- 2016-02
- Volume
- 12
- Issue
- 2
- Pages
- 350-356
- ISSN
- 1550-7289 (ISSN-L)
- OpenAlex
- W2172931772
- Cited by
- 81
- References
- 26
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 7 · 2023: 5 · 2022: 15 · 2021: 17 · 2020: 7 · 2019: 7 · 2018: 6 · 2017: 5 · 2016: 4
- FWCI
- 5.03
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Surgery for Obesity and Related Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Keywords
- bariatric surgery, follow-up adherence
- MeSH terms
- Female, Follow-Up Studies, Humans, Male, Middle Aged, Obesity, Morbid, Patient Compliance, Laparoscopy, Prognosis, Retrospective Studies, Weight Loss, Treatment Outcome, Bariatric Surgery, Preoperative Period
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