Chinese patients undergoing Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG)
Care Setting
Postoperative outpatient follow-up in bariatric surgery centers
Key Highlights
Poor follow-up adherence post-bariatric surgery is common, with attrition rates increasing over time and linked to worse outcomes.
Adherence predictors are inconsistent across studies; demographic, disease-related, and social factors influence follow-up attendance.
A mixed-methods study combining quantitative data and qualitative interviews was used to explore adherence determinants in a Chinese population.
Guideline-Based Recommendations
Diagnosis
Identify patients undergoing RYGB or SG and assess baseline demographics, comorbidities, and mental health status preoperatively.
Management
Schedule four postoperative follow-up appointments within the first year: 1 month, 3 months, 6 months, and 12 months.
Define adherence as attending at least three of these four appointments to ensure adequate postoperative care.
Monitoring & Follow-up
Monitor BMI, surgical outcomes, remission of comorbidities, and complications during follow-up visits.
Use registration records and completion of relevant examinations (e.g., blood biochemistry, oral glucose tolerance test) to confirm attendance.
Risks
Recognize that poor follow-up adherence is associated with insufficient weight loss, higher risk of nutritional deficiencies, and postoperative complications.
Patient & Prescribing Data
177 Chinese patients who underwent primary RYGB or SG with at least one year post-surgery follow-up data.
Adherence to follow-up appointments is variable; factors influencing attendance include demographic, disease-related, and social elements explored via mixed methods.
Clinical Best Practices
Implement structured follow-up schedules with clear patient education on the importance of attendance.
Use mixed-methods approaches to identify barriers to follow-up adherence, including personal, family, and social factors.
Tailor interventions to improve adherence based on identified predictors and patient-reported challenges.
A retrospective database study found a low absolute incidence but higher relative hazard of ischemic optic neuropathy following semaglutide initiation.
