Attitudes and knowledge regarding referrals for bariatric surgery among Danish secondary healthcare providers: A national survey.
bariatric surgery
barriers
referral patterns
secondary healthcare providers
Journal
Clinical obesity
ISSN: 1758-8111
Titre abrégé: Clin Obes
Pays: England
ID NLM: 101560587
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
received:
04
12
2019
revised:
11
03
2020
accepted:
13
03
2020
pubmed:
28
5
2020
medline:
20
3
2021
entrez:
28
5
2020
Statut:
ppublish
Résumé
Bariatric surgery induces significant and sustained weight loss and subsequently reduces obesity-related comorbidities. However, only a small percentage of patients with severe obesity undergo bariatric surgery in Denmark. There is limited knowledge about the experiences with and possible reservations to bariatric surgery among secondary healthcare providers. The aim of this cross-sectional study was to investigate referral patterns and knowledge regarding the criteria for bariatric surgery among Danish secondary healthcare providers, treating obesity-related diseases. A questionnaire regarding experiences with and reservations to referring patients for consideration for bariatric surgery, along with thoughts to specific patient cases were sent to several specialists: endocrinologists, obstetricians and gynaecologists, orthopaedic surgeons and otorhinolaryngologists. Most questions required responses on a 5-point Likert scale and frequency distributions were calculated. A total of 345 (44%) specialists responded to the questionnaires. Good knowledge of the criteria for referral to bariatric surgery varied among the specialist from 6% to 68%. One of the main issues was a concern about the medical and surgical postoperative complications, which was a barrier to and influenced referral decisions. Furthermore, specialists were more likely to refer patients to bariatric surgery when patients requested this. Except for endocrinologists, the Danish secondary healthcare specialists interviewed have limited knowledge about bariatric surgery, which results in a reluctance in referring patients. Our results indicate that there is a need to improve knowledge among specialists, regarding the indications, criteria and outcomes for bariatric surgery to establish a more pro-active, specialist led approach to referrals.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e12369Informations de copyright
© 2020 World Obesity Federation.
Références
Ponce J, Nguyen NT, Hutter M, Sudan R, Morton JM. American Society for Metabolic and Bariatric Surgery estimation of bariatric surgery procedures in the United States, 2011-2014. Surg Obes Relat Dis. 2015;11:1199-1200. https://doi.org/10.1016/j.soard.2015.08.496.
Pedersen SB, Kristiansen V, Gribsholt SB, et al. Dansk Fedmekirurgiregister Årsrapport 2017; 2018. https://www.sundhed.dk/content/cms/22/14022_dk_fedmekirurgiregister_årsrapport_2015.pdf. Accessed mmm dd, yyyy.
Stolberg C, Hepp N, Juhl AJA, Deepti BC, Juhl CB. Primary care physician decision making regarding referral for bariatric surgery: a national survey. Surg Obes Relat Dis. 2018;13(5):807-813. https://doi.org/10.1016/j.soard.2017.02.002.
Mcglone ER, Wing LR, Munasinghe A, Batterham RL, Reddy M, Khan OA. A pilot study of primary care physicians' attitude to weight loss surgery in England: are the young more prejudiced? Surg Obes Relat Dis. 2018;14:376-380. https://doi.org/10.1016/j.soard.2017.11.013.
Martini F, Lazzati A, Fritsch S, Liagre A, Iannelli A, Paolino L. General practitioners and bariatric surgery in France: are they ready to face the challenge? Obes Surg. 2018;28:1754-1759.
Sjöström L. Bariatric surgery and reduction in morbidity and mortality: experiences from the SOS study. Int J Obes (Lond). 2008;32:93-97. https://doi.org/10.1038/ijo.2008.244.
Peromaa-Haavisto P, Tuomilehto H, Kössi JE, Virtanen J, Luostarinen M, Pihlajam J. Obstructive sleep apnea: the effect of bariatric surgery after 12 months. A prospective multicenter trial. Sleep Med. 2018;35:85-90. https://doi.org/10.1016/j.sleep.2016.12.017.
Milone M, De Placido G, Musella M, et al. Incidence of successful pregnancy after weight loss interventions in infertile women: a systematic review and meta-analysis of the literature. Obes Surg. 2016;26:443-451. https://doi.org/10.1007/s11695-015-1998-7.
Springer BD, Carter JT, Mclawhorn AS, et al. Obesity and the role of bariatric surgery in the surgical management of osteoarthritis of the hip and knee: a review of the literature. Surg Obes Relat Dis. 2018;13:111-118. https://doi.org/10.1016/j.soard.2016.09.011.
Wolski K, Aminian A, Brethauer SA. Bariatric surgery versus intensive medical therapy for diabetes-5-year outcomes. The New England Journal of Medicine. 2017;376:641-651. https://doi.org/10.1056/NEJMoa1600869.
Avidor Y, Still CD, Brunner M, Buchwald JN, Buchwald H. Primary care and subspecialty management of morbid obesity: referral patterns for bariatric surgery. Surg Obes Relat Dis. 2007;3:392-407. https://doi.org/10.1016/j.soard.2006.12.003.
Simon R, Lahiri SW. Provider practice habits and barriers to care in obesity management in a large multicenter health system. Endocr Pr. 2018;24(4):321-328. https://doi.org/10.4158/EP-2017-0221.
Primomo JA, Kajese T, Davis G, et al. Decreased access to bariatric care: an analysis of referral practices to bariatric specialists. Surg Obes Relat Dis. 2016;12:1725-1730. https://doi.org/10.1016/j.soard.2016.08.016.
Gantzhorn EK, Gottlieb V, Wessels J, Tønnesen P. Dansk lungemedicinsk selvskab. Søvnapnø; 2018. https://www.lungemedicin.dk/fagligt/74-soevnapnoe.html. Accessed January 21, 2019.
Snorgaard O, Hansen KB, Bjerregaard-Andersen M, et al. Dansk endokrinologisk selvskab. NBV: Behandling og kontrol af Type 2 diabetes; 2018. http://www.endocrinology.dk/index.php/nbvhovedmenu/1-diabetes-mellitus/nbv-endokrinologi-behandling-og-kontrol-af-type-2-diabetes-t2d-diabetes-arskontrol-nyopdaget-diabetes-2-peroral-behandling-insulin-behandling-kolesterolbehandling-blodtryksbehandling-g. Accessed mmm dd, yyyy.
Care D, Suppl SS. 8. Obesity management for the treatment of type 2 diabetes: standards of medical care in diabetes-2019. Diabetes Care. 2019;42(Suppl 1):S81-S89. https://doi.org/10.2337/dc19-S008.
Dudley KA, Tavakkoli A, Andrews RA, Seiger AN, Bakker JP, Patel SR. Interest in bariatric surgery among obese patients with obstructive sleep apnea. 2016;11(5):1146-1151. https://doi.org/10.1177/0333102415576222.Is.
Funk LM, Jolles SA, Greenberg CC, et al. Primary care physician decision making regarding severe obesity treatment and bariatric surgery: a qualitative study. Surg Obes Relat Dis. 2016;12(4):893-901. https://doi.org/10.1016/j.soard.2015.11.028.
Wharton S, Serodio KJ, Kuk J, Sivapalan N, Craik A, Aarts M-A. Interest, views and perceived barriers to bariatric surgery in patients with morbid obesity. Clin Obes. 2016;6(2):154-160. https://doi.org/10.1111/cob.12131.
Lopez EK, Helm MC, Gould JC, Lak KL. Primary care providers' attitudes and knowledge of bariatric surgery. Surg Endosc. 2019;34:2273-2278. https://doi.org/10.1007/s00464-019-07018-z.
Rønningen R, Wammer ACP, Grabner NH, Valderhaug TG. Associations between lifetime adversity and obesity treatment in patients with morbid obesity. Obes Facts. 2019;12:1-13. https://doi.org/10.1159/000494333.