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Global variations in preoperative practices concerning patients seeking primary bariatric and metabolic surgery (PACT Study): a survey of 634 bariatric healthcare professionals

Graham, Yitka (2022) Global variations in preoperative practices concerning patients seeking primary bariatric and metabolic surgery (PACT Study): a survey of 634 bariatric healthcare professionals. International Journal of Obesity. ISSN 1476-5497 (In Press)

Item Type: Article

Abstract

Background Bariatric and Metabolic Surgery (BMS) is a popular weight-loss intervention worldwide, yet few scientific studies have examined variations in preoperative practices globally. This study aimed to capture global variations in preoperative practices concerning patients planned for BMS.

Methods A 41-item questionnaire-based survey was designed and the survey link was freely distributed on social and scientific media platforms, email groups and circulated through personal connections of authors. The survey included eight parts: basic information; criteria for BMS; preoperative nutritional screening; preoperative weight loss; preoperative diets for liver size reduction; preoperative glycemic control; other laboratory investigations and preparations; decision making, education, and consents. Descriptive statistics were used to analyse data and graphs were used for representation where applicable.

Results Six hundred thirty-four bariatric healthcare professionals from 76 countries/regions completed the survey. Of these, n=310 (48.9%) were from public hospitals, n=466 (73.5%) were surgeons, and the rest were multidisciplinary professionals. More than half of respondents reported using local society/association guidelines in their practice (n=310, 61.6%). The great majority of respondents routinely recommend nutritional screening preoperatively (n=385, 77.5%), mandatory preoperative diets for liver size reduction (n=220, 53.1%), routine screening for T2DM (n=371, 90.7%), and mandate a glycemic control target before BMS in patients with T2DM (n=203, 55.6%). However, less than half (n=183, 43.9%) recommend mandatory preoperative weight loss to all patients. Most respondents (n=296, 77.1%) recommend psychological intervention before surgery for patients diagnosed with psychological conditions. Variations were also identified in laboratory investigations and optimisation; and in the aspects of decision making, education and consent.

Conclusions This survey identified significant global variations in preoperative practices concerning patients seeking primary BMS. Our findings could facilitate future research for the determination of best practice in these areas of variations, and consensus-building to guide clinical practice while we wait for that evidence to emerge.

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More Information

Depositing User: Yitka Graham

Identifiers

Item ID: 14714
ISSN: 1476-5497
URI: http://sure.sunderland.ac.uk/id/eprint/14714

Users with ORCIDS

ORCID for Yitka Graham: ORCID iD orcid.org/0000-0002-6206-1461

Catalogue record

Date Deposited: 04 Apr 2022 13:59
Last Modified: 04 Apr 2022 13:59

Contributors

Author: Yitka Graham ORCID iD

University Divisions

Faculty of Health Sciences and Wellbeing > School of Nursing and Health Sciences

Subjects

Sciences > Nursing

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