scholarly journals Serious Impacts of Postponing Bariatric Surgery as a Result of the COVID-19 Pandemic: The Patient Perspective

2021 ◽  
Vol 8 ◽  
pp. 237437352110082
Author(s):  
Babur Ahmed ◽  
Mohammad Altarawni ◽  
Jodi Ellison ◽  
Bilal H Alkhaffaf
Keyword(s):  
Bariatric Surgery ◽  
Health Care ◽  
Weight Loss ◽  
Thematic Analysis ◽  
Patient Perspective ◽  
Online Survey ◽  
Qualitative Data ◽  
Elective Surgery ◽  
Physical Symptoms ◽  
Psychological Effects

Background: The global COVID-19 pandemic has resulted in the widespread suspension of bariatric surgical programs. Although this rapid adaption was initially necessary, the implications of delaying the most effective treatment for weight loss in a population at risk from this crisis are not well known. Moreover, as the health care trusts plan the reintroduction of elective services, it is vital to also consider the patient’s perspectives, to adequately weigh up the benefits and risks of this recommencement in the current climate. Objectives: We aimed to investigate the impacts that postponing bariatric surgery has had on patients, and their priorities when restarting elective surgery. Methods: An online survey of patients awaiting surgery was undertaken, examining the physical and psychological impacts of pandemic isolation policies and postponing surgery, and exploring patient preferences regarding surgery during the pandemic. Results: Of 71 patients, 67.6% gained a median of 4 kg (interquartile range: 2.6-6.4), and 74.6% had adverse psychological effects; 93.0% were keen to proceed with surgery. Thematic analysis of qualitative data revealed delays have worsened physical symptoms, increased anxiety, and delayed secondary life-altering treatments. Conclusion: From the patient’s perspective, postponing surgery has been deleterious and efforts to safely reintroduce bariatric programs should be promoted.

scholarly journals “The most lonely condition I can imagine”: Psychosocial impacts of endometriosis on women’s identity

2020 ◽  
pp. 095935352093060
Author(s):  
Jennifer M Cole ◽  
Sarah Grogan ◽  
Emma Turley
Keyword(s):  
Chronic Pain ◽  
Social Relationships ◽  
Thematic Analysis ◽  
Online Survey ◽  
Qualitative Data ◽  
Physical Symptoms ◽  
Role Expectations ◽  
Social Connections ◽  
Women's Identity ◽  
Psychosocial Impacts

Endometriosis is a condition which affects around 1–2% of women worldwide and has profound effects on their everyday lives. Previous research has tended to focus on physical symptoms (such as chronic pain); how women manage changes to their identity and relationships as a result of endometriosis has received less attention. This paper discusses qualitative data examining how women negotiate changes to identity while living with endometriosis, in a social context where women are expected to minimise their symptoms and conform to feminine role expectations. We conducted thematic analysis of 34 replies to an online survey seeking qualitative text responses. The women identified disruptions to personal identity as a result of living with endometriosis. They talked about not feeling like themselves (Theme 1) and about reactions from medical and social connections prompting feelings that they were going “mad” (Theme 2). Participants also expressed feeling as though they were a burden to loved ones (Theme 3), which often resulted in self-silencing (Theme 4). Findings are discussed in the context of Western expectations of women’s roles in social relationships and suggest that professionals who support women with endometriosis should be aware of strategies such as self-silencing which may reduce effective self-care.

Trends in pediatric obesity management, a survey from the Pediatric Endocrine Society Obesity Committee

2020 ◽  
Vol 33 (4) ◽  
pp. 469-472 ◽  
Author(s):  
Ashley H. Shoemaker ◽  
Stephanie T. Chung ◽  
Amy Fleischman ◽  
_ _
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Pediatric Obesity ◽  
Online Survey ◽  
Treatment Options ◽  
The United States ◽  
Pediatric Endocrinology ◽  
Lifestyle Modifications ◽  
Endocrine Society ◽  
Weight Loss Medications

AbstractBackgroundIn the United States, 18.5% of children are obese. Dietary and lifestyle modifications are key, but often ineffective. There are limited approved pediatric pharmacotherapies. The objective of this study was to evaluate current treatment practices for pediatric obesity among members of the Pediatric Endocrine Society (PES, n = 1300) and the Pediatric Obesity Weight Evaluation Registry (POWER, n = 42) consortium.MethodsA 10-question online survey on treatment of children with obesity in clinical practice was conducted.ResultsThe response rates were 19% for PES and 20% for POWER members. The majority were female (65%) and board certified in pediatric endocrinology (81%). Most practitioners saw 5–10 patients with obesity/week and 19% prescribed weight-loss medications. POWER participants were more likely to prescribe weight-loss medications than PES participants (46% vs. 18%, p =  0.02). Metformin was the most commonly prescribed medication. Response to medication was poor. Use of dietary non-pharmacological treatment options was uncommon. Over half of the respondents (56%) referred patients for bariatric surgery and 53% had local access to pediatric bariatric surgery.ConclusionsMetformin was the most common drug prescribed among respondents, but successful weight-loss responses were uncommon. Among practitioners who are using pharmacological interventions, therapeutic strategies vary widely. Targeted research in pharmacologic and surgical treatment for pediatric obesity is urgently needed.

scholarly journals Digital Support for Patients Undergoing Bariatric Surgery: Narrative Review of the Roles and Challenges of Online Forums (Preprint)

2019 ◽  
Author(s):  
Anna Robinson ◽  
Andrew K Husband ◽  
Robert D Slight ◽  
Sarah P Slight
Keyword(s):  
Bariatric Surgery ◽  
Health Care ◽  
Weight Loss ◽  
Health Care Professionals ◽  
Well Being ◽  
Narrative Review ◽  
Future Research ◽  
Accurate Information ◽  
Online Forums ◽  
Care Giving

BACKGROUND The internet has become an important medium within health care, giving patients the opportunity to search for information, guidance, and support to manage their health and well-being needs. Online forums and internet-based platforms appear to have changed the way many patients undergoing bariatric surgery view and engage with their health, before and after weight loss surgery. Given that significant health improvements result from sustained weight loss, ensuring patient adherence to recommended preoperative and postoperative guidance is critical for bariatric surgery success. In a patient cohort with high information needs preoperatively, and notoriously high attrition rates postoperatively, online forums may present an underutilized method of support. OBJECTIVE The aim of this study was to conduct a narrative review focusing on the developing roles that online forums can play for patients with bariatric conditions preoperatively and postoperatively. METHODS A literature search was conducted in October-November 2019 across 5 electronic databases: Scopus, EMBASE, PsycINFO, CINAHL, and MEDLINE. Qualitative or mixed methods studies were included if they evaluated patients undergoing bariatric surgery (or bariatric surgery health care professionals) engaging with, using, or analyzing online discussion forums or social media platforms. Using thematic analysis, themes were developed from coding patterns within the data to identify the roles and challenges of online forums for patients undergoing bariatric surgery. RESULTS A total of 8 studies were included in this review, with 5 themes emerging around (1) managing expectations of a <i>new life</i>; (2) decision making and signposting; (3) supporting information seeking; (4) facilitating connectedness: peer-to-peer social and emotional support; and (5) enabling accessibility and connectivity with health care professionals. CONCLUSIONS Online forums could offer one solution to improving postoperative success by supporting and motivating patients. Future research should consider how best to design and moderate online forums for maximal effectiveness and the sharing of accurate information. The surgical multidisciplinary team may consider recommendations of online peer-support networks to complement care for patients throughout their surgical journey.

scholarly journals Chronic abdominal pain and persistent opioid use after bariatric surgery

2020 ◽  
Vol 20 (2) ◽  
pp. 239-251 ◽  
Author(s):  
Amalie H. Simoni ◽  
Louise Ladebo ◽  
Lona L. Christrup ◽  
Asbjørn M. Drewes ◽  
Søren P. Johnsen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bariatric Surgery ◽  
Health Care ◽  
Weight Loss ◽  
Abdominal Pain ◽  
Pain Treatment ◽  
Chronic Abdominal Pain ◽  
Adverse Outcomes ◽  
Opioid Use ◽  
Pain Status

AbstractBackground and aimsBariatric surgery remains a mainstay for treatment of morbid obesity. However, long-term adverse outcomes include chronic abdominal pain and persistent opioid use. The aim of this review was to assess the existing data on prevalence, possible mechanisms, risk factors, and outcomes regarding chronic abdominal pain and persistent opioid use after bariatric surgery.MethodsPubMed was screened for relevant literature focusing on chronic abdominal pain, persistent opioid use and pharmacokinetic alterations of opioids after bariatric surgery. Relevant papers were cross-referenced to identify publications possibly not located during the ordinary screening.ResultsEvidence regarding general chronic pain status after bariatric surgery is sparse. However, our literature review revealed that abdominal pain was the most prevalent complication to bariatric surgery, presented in 3–61% of subjects with health care contacts or readmissions 1–5 years after surgery. This could be explained by behavioral, anatomical, and/or functional disorders. Persistent opioid use and doses increased after bariatric surgery, and 4–14% initiated a persistent opioid use 1–7 years after the surgery. Persistent opioid use was associated with severe pain symptoms and was most prevalent among subjects with a lower socioeconomic status. Alteration of absorption and distribution after bariatric surgery may impact opioid effects and increase the risk of adverse events and development of addiction. Changes in absorption have been briefly investigated, but the identified alterations could not be separated from alterations caused solely by excessive weight loss, and medication formulation could influence the findings. Subjects with persistent opioid use after bariatric surgery achieved lower weight loss and less metabolic benefits from the surgery. Thus, remission from comorbidities and cost effectiveness following bariatric surgery may be limited in these subjects.ConclusionsPain, especially chronic abdominal, and persistent opioid use were found to be prevalent after bariatric surgery. Physiological, anatomical, and pharmacokinetic changes are likely to play a role. However, the risk factors for occurrence of chronic abdominal pain and persistent opioid use have only been scarcely examined as have the possible impact of pain and persistent opioid use on clinical outcomes, and health-care costs. This makes it difficult to design targeted preventive interventions, which can identify subjects at risk and prevent persistent opioid use after bariatric surgery. Future studies could imply pharmacokinetic-, pharmacodynamics-, and physiological-based modelling of pain treatment. More attention to social, physiologic, and psychological factors may be warranted in order to identify specific risk profiles of subjects considered for bariatric surgery in order to tailor and optimize current treatment recommendations for this population.

scholarly journals Effectiveness of Gastric Bypass Versus Gastric Sleeve for Cardiovascular Disease: Protocol and Baseline Results for a Comparative Effectiveness Study

10.2196/14936 ◽  
2020 ◽  
Vol 9 (4) ◽  
pp. e14936
Author(s):  
Karen J Coleman ◽  
Heidi Fischer ◽  
David E Arterburn ◽  
Douglas Barthold ◽  
Lee J Barton ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Bariatric Surgery ◽  
Health Care ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Cohort Study ◽  
Health Care System ◽  
Comparative Effectiveness ◽  
Gastric Sleeve

Background When compared with conventional weight loss strategies, bariatric surgery results in substantially greater durable weight loss and rates of disease remission. Objective The ENGAGE CVD (Effectiveness of Gastric Bypass versus Gastric Sleeve for Cardiovascular Disease) cohort study aimed to provide population-based, comprehensive, rigorous evidence for clinical and policy decision making regarding the choice between gastric bypass and gastric sleeve for overall cardiovascular disease (CVD) risk reduction, risk factor remission, and safety. Methods The cohort had 22,095 weight loss surgery patients from a large integrated health care system in Southern California assembled from 2009 to 2016 who were followed up through 2018. Bariatric surgery patients were followed up for the length of their membership in the health care system. Of the patients who had at least five years of follow-up (surgery between 2009 and 2013), 85.86% (13,774/16,043) could contribute to the outcome analyses for the ENGAGE CVD cohort. Results Patients in the ENGAGE CVD cohort were 44.6 (SD 11.4) years old, mostly women (17,718/22,095; 80.19%), with 18.94% (4185/22,095) non-Hispanic black and 41.80% (9235/22,095) Hispanic, and had an average BMI of 44.3 (SD 6.9) kg/m2 at the time of surgery. When compared with patients who did not contribute data to the 5-year outcome analysis for the ENGAGE CVD cohort (2269/16,043; 14.14%), patients who contributed data (13,774/16,043; 85.86%) were older (P=.002), more likely to be women (P=.02), more likely to be non-Hispanic white (P<.001), more likely to have had an emergency department visit in the year before surgery (P=.006), less likely to have a mental illness before surgery (P<.001), and more likely to have had a CVD event at any time before surgery (P<.001). Conclusions This study had one of the largest populations of gastric sleeve patients (n=13,459). The 5-year follow-up for those patients who had surgery between 2009 and 2013 was excellent for a retrospective cohort study at 85.86% (13,774/16,043). Unlike almost any study in the literature, the majority of the ENGAGE CVD cohort was racial and ethnic minority, providing a rare opportunity to study the effects of bariatric surgery for different racial and ethnic groups, some of whom have the highest rates of severe obesity in the United States. Finally, it also used state-of-the-art statistical and econometric comparative effectiveness methods to mimic the effect of random assignment and control for sources of confounding inherent in large observational studies. International Registered Report Identifier (IRRID) RR1-10.2196/14936

Effect of Surgical Weight Loss on Plantar Fasciitis and Health-Care Use

2018 ◽  
Vol 108 (6) ◽  
pp. 442-448 ◽  
Author(s):  
Mena Boules ◽  
Esam Batayyah ◽  
Dvir Froylich ◽  
Andrea Zelisko ◽  
Colin O'Rourke ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Health Care ◽  
Weight Loss ◽  
Plantar Fasciitis ◽  
Excess Weight Loss ◽  
Health Care Use ◽  
Excess Weight ◽  
Treatment Modalities ◽  
The Mean ◽  
Number Of Treatment

Background: Plantar fasciitis (PF) is one of the most common causes of heel pain. Obesity is recognized as a major factor in PF development, possibly due to increased mechanical loading of the foot due to excess weight. The benefit of bariatric surgery is documented for other comorbidities but not for PF. Methods: A retrospective medical record review was performed for patients with PF identified from a prospectively maintained database of the Cleveland Clinic Bariatric and Metabolic Institute. Age, sex, surgery, excess weight loss, body mass index (BMI), and health-care use related to PF treatment were abstracted. Comparative analyses were stratified by surgery type. Results: Two hundred twenty-eight of 10,305 patients (2.2%) had a documented diagnosis of PF, of whom 163 underwent bariatric surgery and were included in the analysis. Eighty-five percent of patients were women, mean ± SD age was 52.2 ± 9.9 years, and mean ± SD preintervention BMI was 45 ± 7.7. Postoperatively, mean ± SD BMI and excess weight loss were 34.8 ± 7.8 and 51.0% ± 20.4%, respectively. One hundred forty-six patients (90%) achieved resolution of PF and related symptoms. The mean ± SD number of treatment modalities used for PF per patient preoperatively was 1.9 ± 1.0 (P = .25). After surgery, the mean ± SD number of treatment modalities used per patient was reduced to 0.3 ± 0.1 (P = .01). Conclusions: We present new evidence suggesting that reductions in BMI after bariatric surgery may be associated with decreasing the number of visits for PF and may contribute to symptomatic improvement.

scholarly journals Codesigning a supportive online resource for Australian cancer carers: a thematic analysis of informal carers’ and healthcare professionals’ perspectives about carers’ responsibilities and content needs

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e055026
Author(s):  
Sharnel Miriam Perera ◽  
Clare O’Callaghan ◽  
Anna Ugalde ◽  
Olinda Santin ◽  
Cassandra Beer ◽  
...  
Keyword(s):  
Thematic Analysis ◽  
Online Survey ◽  
Qualitative Data ◽  
Healthcare Professionals ◽  
Telephone Interview ◽  
Rural And Urban ◽  
Online Resource ◽  
Informal Carers ◽  
Informal Supports ◽  
User Friendly

ObjectiveTo gather preliminary qualitative data that will assist in the codesign and development of a new informational and supportive website to assist informal cancer carers in Australia.Design and settingUtilising a previously tested codesign process, informal carers’ experiences and perspectives, including those of healthcare professionals’, were examined via focus groups and/or interviews. Data were analysed via thematic analysis.ParticipantsRural (n=9) and urban (n=11) carers’, and healthcare professionals’ (n=8) perspectives were collected. Carers participated in a focus group (n=9) or telephone interview (n=11). Healthcare professionals completed an interview (n=6) or online survey (n=2).ResultsRural and urban carers typically felt ill prepared for their multitudinal caregiving responsibilities. Supporting patient-to-healthcare professional liaisons could especially challenge. Carers’ biopsychosocial and fiscal strains were affected by patients’ hardships and available informal supports. Rural carers described greater social support than urban carers. Both rural and urban carers also described discontentment related to a carer neglecting healthcare system. Both carers and healthcare professionals endorsed the need for a user-friendly, carer-specific website encompassing practical information and resources, peer-driven advice and evidence-based illness information, tailored to the Australian context.ConclusionsCarers and healthcare professionals recognise the pressing need for an Australian, cancer carer-specific online resource. Findings will inform the next phase, where a resource will be designed, developed and tested.

scholarly journals To Get Back on Track: A Qualitative Study on Childless Women’s Expectations on Future Fertility Before Undergoing Bariatric Surgery

2019 ◽  
Vol 13 ◽  
pp. 117955811987477 ◽  
Author(s):  
Emma Nilsson-Condori ◽  
Stina Järvholm ◽  
Ann Thurin-Kjellberg ◽  
Ilona Sidlovskaja ◽  
Jan L Hedenbro ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Qualitative Study ◽  
Young Women ◽  
Thematic Analysis ◽  
Obese Women ◽  
Structured Interviews ◽  
Childless Women ◽  
Future Fertility

Background: In Sweden, 4700 women seek bariatric surgery annually, many of those being nulliparous. Anovulation is common among obese women, but bariatric surgery is not considered a treatment for infertility. The aim of this study was to explore the motives of women in fertile age for seeking bariatric surgery and their expectations on future fertility. Materials and methods: A qualitative study with semi-structured interviews with childless women ( n = 12) aged 20 to 35 years. Interviews were conducted 1 to 3 weeks prior to surgery, transcribed verbatim, and analyzed with thematic analysis. Results: “To get back on track” was identified as a master theme with 3 underlying subthemes, with the following headings: “A better me,” “A fertile me,” and “A pregnant me.” The participants were hoping that weight-loss would make them feel more content with themselves, break isolation, and make it easier to find a partner. The participants considered fertility to improve after bariatric surgery, mainly based on stories from other patients of bariatric surgery. Having a child was expressed to be of great importance to them. Conclusions: Even though obese young women do not seek bariatric surgery for fertility reasons alone, there is a general perception of enhanced fertility after surgery, which is regarded as positive and important.

A428 Adherence to health care appointments is associated with weight loss following bariatric surgery

2019 ◽  
Vol 15 (10) ◽  
pp. S174
Author(s):  
Kellie Martens ◽  
Bethany Pester ◽  
Leah Hecht ◽  
Shannon Clark ◽  
Aaron Hamann ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Health Care ◽  
Weight Loss

scholarly journals Orthopaedic surgeons’ perceptions on COVID-19 related changes in practice: an international survey

2020 ◽  
Author(s):  
Nadhir Meraghni ◽  
Hichem Bouyoucef ◽  
Nacim soal ◽  
Redouane Si Larbi ◽  
Riad Benkaidali ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care ◽  
Orthopaedic Surgery ◽  
Online Survey ◽  
Current Practice ◽  
Elective Surgery ◽  
International Survey ◽  
Orthopaedic Surgeons ◽  
Outpatient Visits ◽  
Plan Management

Abstract Purpose The purpose of this study was to assess the orthopaedic surgeons’ perceptions on COVID-19 related changes in their practice.MethodsAn online survey was shared with orthopaedic surgeons practicing in different countries.ResultsThis study showed that orthopaedic surgery plan management was adapted to respond more effectively to the COVID-19 pandemic while maintaining the continuity of health care and ensuring protection of medical staff and patients. Among the introduced measures, elective surgery was postponed to free-up beds for suspected or COVID-19 positive patients requiring hospitalization. Additionally, the number of outpatient visits was considerably decreased and non-urgent visits were postponed to reduce the flow of patients in and out of hospitals and therefore minimize the risk of contamination. Interestingly, data revealed the willingness of orthopaedic surgeons to take care of COVID-19 positive patients and support their colleagues in intensive care units, if needed.ConclusionsThough, orthopaedic surgeons are not in the frontline, they have an important role to play to face the increasing pressure due to the COVID-19 pandemic. In addition to the changes imposed in their current practice, they have a role in providing support to other colleagues in the fight against this global crisis.

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