Online survey on factors influencing patients' motivation to undergo bariatric surgery

Attitudes of primary care physicians toward bariatric surgery: a free word association networks analysis

BACKGROUND

Primary care physicians (PCPs) hold major responsibility in referring patients with obesity eligible for bariatric surgery (BS).

OBJECTIVE

The aim was to explore PCPs' mental representation of BS in order to identify barriers and catalysts of BS referral practices.

SETTING

Switzerland.

METHODS

A total of 3526 PCPs were invited to participate in an online survey. PCPs were asked to write the first 5 words that came to their mind about the term "bariatric surgery." Additionally, they had to pick 2 emotions that best described each provided association. Demographic data and obesity-related referral patterns were collected. Mental representation network was constructed based on co-occurrence of associations, using validated data-driven methodology.

RESULTS

In all, 216 PCPs completed the study (response rate: 6.13%). Respondents were aged 55 ± 9.8 years, had an equal sex distribution, and practiced mainly in urban settings. Three mental representations of BS emerged: indication-focused (most frequent associations: "obesity," "diabetes"), treatment-focused ("gastric bypass," "weight loss"), and outcome-focused ("complications," "challenging follow-up"). The emotional label "interested" was used significantly more frequently in the treatment-focused group. Comparison of PCPs among mental modules showed that those with a treatment-focused mindset referred patients for BS most frequently and were significantly more willing to follow up with postbariatric patients (χ2 = 17.8, P = .022).

CONCLUSIONS

PCPs think about BS along 3 mental representations, and the treatment-focused attitude was coupled with the highest willingness to refer eligible patients for BS. Confidence in performing postbariatric follow-up was identified as catalyst of BS referral. Access to optimal care for patients with obesity may be improved accordingly.

The Effect of a Multifaceted Intervention Including Classroom Education and Bariatric Weight Suit Use on Medical Students' Attitudes toward Patients with Obesity

INTRODUCTION

Weight bias refers to negative attitudes toward individuals because of their weight. Evidence-based strategies to successfully reduce weight bias in medical students are lacking. The purpose of this study was to investigate the impact of a multifaceted intervention on medical students' attitudes toward patients with obesity.

METHODS

Third and fourth year medical students (n = 79), who enrolled in an 8-week graduate course focusing on the various epidemiologic, physiological, and clinical aspects of obesity, including a gamification task with bariatric weight suits (BWSs), were asked to complete the Nutrition, Exercise and Weight Management (NEW) Attitudes Scale questionnaire pre- and post-course. The inclusion period was between September 2018 and June 2021 and covered 4 consecutive groups of students.

RESULTS

The overall NEW Attitudes Scale scores did not change significantly pre- versus post-intervention (pre-course: 19.59, post-course: 24.21, p value = 0.24). However, the subgroup of 4th year medical students showed a significant improvement in their attitudes (pre-course: 16.4, post-course: 26.16, p value = 0.02). The Thurstone rating of 9 out of 31 individual survey items changed significantly from pre- to post-course with a moderate strength (Cramer's V >0.2), including 5 items showing weight bias reduction. The disagreement with the statement "overweight/obese individuals lack willpower" increased from 37 to 68%.

CONCLUSION

These findings suggest that in medical students with a low level of weight bias at baseline, a semester course on obesity combined with BWS use affects only a limited number of items of the NEW Attitudes Scale questionnaire. The sensitization of medical students to weight stigma has the potential to improve quality of healthcare for patients with obesity.

Marketing factors associated with a continuous positive airway pressure machine purchasing in patients with obstructive sleep apnea

Aim: Obstructive sleep apnea (OSA) is related with several cardiovascular diseases. It should be treated with a continuous positive airway pressure (CPAP) machine. There is limited data on marketing factors on a decision of CPAP machine purchasing in OSA patients. Materials & methods: We enrolled adult patients aged over 18 years with OSA who tried a CPAP. Marketing factors were evaluated for a decision of CPAP machine purchasing. Results: There were 95 OSA patients participated in the study. Nice color CPAP machine and good knowledge and informative salesperson had adjusted odds ratio (aOR) of 4.480 and 9.478, the other two factors had aOR at 0.102 and 0.217. Conclusion: Marketing factors related to CPAP machine purchasing in patients with OSA.

Barriers to Coronavirus Disease 19 vaccination in patients with obesity

BACKGROUND

Patients with obesity are at a high risk of severe disease and death from Coronavirus Disease 2019 (COVID-19). Vaccination offers a safe and effective means of reducing this risk. The rate of COVID-19 vaccine refusal in patients with obesity is unknown.

METHODS

Patients with obesity were administered validated questionnaires assessing COVID-19 fear, general vaccine hesitancy, and COVID-19-specific vaccine hesitancy.

RESULTS

507 participants completed the study. COVID-19 vaccine hesitancy was high: Fifteen percent of patients refused COVID-19 vaccine. Hesitancy related to other vaccines was also high: Eight percent of patients refused a vaccine in the past, and 15% delayed a vaccine. Fear of side effects and doubts regarding effectiveness were the most common reasons for vaccine refusal.

CONCLUSIONS

Despite high risk for complications, vaccine hesitancy is high among patients with obesity. Targeted public health interventions are critical to reduce vaccine hesitancy and improve vaccination rates.

Patient perspectives on the usefulness of the MBSAQIP Bariatric Surgical Risk/Benefit Calculator: a randomized controlled trial

BACKGROUND

The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) Bariatric Surgical Risk/Benefit Calculator uses procedure-specific prediction models to generate individualized surgical risk/outcome estimates. This tool helps guide informed consent and operative selection. We hypothesized that calculator use would influence patient procedure choice.

OBJECTIVE

To assess patient perspectives on the bariatric surgical calculator.

SETTING

A randomized controlled trial at an MBSAQIP-accredited center.

METHODS

During the preoperative bariatric surgical office consultation, patients were randomized into 2 groups: the control group received conventional surgeon-led counseling, whereas surgeons used the risk/benefit calculator to guide decision making for the calculator group. Surveys were completed by patients following consultations to evaluate satisfaction and perceived impact of the risk/benefit calculator on operative selection.

RESULTS

Between 2020 and 2022, 61 patients were randomized to the calculator group and 68 patients to the control group. The percentage of patients whose procedure of choice changed following consultation was similar in the calculator versus control group (44.3% versus 41.2%; P = .723). However, calculator group patients were less likely to perceive surgeon counseling as very important for their decision making (43.3% versus 76.5%; P < .001). Eighty-five percent of calculator group patients rated the calculator as useful or very useful, and only 1.7% found it not very important. The reasons patients changed procedure choice were similar between the groups (P = .091); the most common cause was to improve their anticipated outcome (48.7% versus 54.8%).

CONCLUSIONS

While the risk/benefit calculator was perceived as a helpful tool by most patients, its use did not influence their procedure choice. However, the patient-reported usefulness and importance of the calculator during surgeon counseling suggest that the information provided has weight in patient decision making.