Adherence to health care appointments is associated with weight loss following bariatric surgery
Martens K, Pester B, Hecht L, Clark S, Hamann A, Carlin A, and Miller-Matero L. Adherence to health care appointments is associated with weight loss following bariatric surgery. Surg Obes Relat Dis 2019; 15(10):S174.
Surg Obes Relat Dis
Background: Many bariatric surgery programs consider adherence to health care appointments necessary to provide optimal care and evaluate long-term outcomes. This study examined the relationship between pre- and post-operative adherence to appointments and weight loss. Methods: Participants (N=210) included patients who underwent sleeve gastrectomy or Roux-en-Y gastric bypass. A retrospective chart review was used to determine percentage of canceled, “no-showed,” and completed appointments two years prior to and 1 year after bariatric surgery. Weight outcomes at 1-year (+/-3 months), including change in BMI (ΔBMI), percent total weight loss (%TWL), and percent excess weight loss (%EWL) were calculated. Results: Participants were predominantly female (84.3%), Caucasian (49%) or African American (42.4%), with a mean age of 46 years and pre-surgical BMI of 46. Approximately half (45.7%) of patients did not attend their 1-year surgical follow-up appointment. A higher rate of canceled post-operative bariatric appointments was related to lower ΔBMI (β= -.17, p=.029) and %TWL (β= -.17, p=.037), but not %EWL. Pre-operative “no-shows” were inversely related to completed post-operative bariatric appointments (β= -.14, p=.045) and predicted more post-operative “no-shows” (β=.34, p<.001). Younger age predicted higher rates of “no-shows” (β= -.22, p=.002) and fewer completed appointments (β=.14, p=.049). Conclusions: There are high rates of nonadherence to bariatric appointments in the year after surgery. Pre-surgical nonadherence to health care appointments may predict nonadherence to post-surgical bariatric appointments. Future research could examine ways to improve retention of bariatric patients as post-operative nonadherence to appointments may be associated with less weight loss.