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

Wah Yang; Sally Abbott; Cynthia Michelle Borg; Paul Chesworth; Yitka Graham; Jennifer Logue; Jane Ogden; Mary O’Kane; Denise Ratcliffe; Shiri Sherf-Dagan; Rishi Singhal; Vanessa Snowdon-Carr; Abd Tahrani; Kamal Mahawar

doi:10.1038/s41366-022-01119-x

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

Wah Yang
, Sally Abbott
, Cynthia Michelle Borg
, Paul Chesworth
, Yitka Graham
, Jennifer Logue
, Jane Ogden
, Mary O’Kane
, Denise Ratcliffe
, Shiri Sherf-Dagan
, Rishi Singhal
, Vanessa Snowdon-Carr
, Abd Tahrani
, Kamal Mahawar

The First Affiliated Hospital of Jinan University
Jinan University
Guangdong-Hong Kong-Macao Joint University Laboratory
University Hospitals Coventry and Warwickshire NHS Trust
University Hospital Lewisham
Patient Representative
University of Sunderland
Universidad Anáhuac México
South Tyneside and Sunderland NHS Foundation Trust
Lancaster Medical School
University of Surrey
Leeds Teaching Hospitals NHS Trust
Phoenix Health
Ariel University
Assuta Medical Center
University Hospitals Birmingham NHS Foundation Trust
University of Birmingham
E-Weightloss Surgery Ltd
Birmingham Health Partners

Research output: Contribution to journal › Article › peer-review

11 Citations (Scopus)

159 Downloads (Pure)

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.

Original language	English
Pages (from-to)	1341-1350
Number of pages	10
Journal	International Journal of Obesity
Volume	46
Issue number	7
Early online date	11 Apr 2022
DOIs	https://doi.org/10.1038/s41366-022-01119-x
Publication status	Published - Jul 2022

Bibliographical note

Copyright © and Moral Rights are retained by the author(s) and/ or other copyright owners. A copy can be downloaded for personal non-commercial research or study, without prior permission or charge. This item cannot be reproduced or quoted extensively from without first obtaining permission in writing from the copyright holder(s). The content must not be changed in any way or sold commercially in any format or medium without the formal permission of the copyright holders.

This document is the author’s post-print version, incorporating any revisions agreed during the peer-review process. Some differences between the published version and this version may remain and you are advised to consult the published version if you wish to cite from it.

Funding

MOK has been paid honoraria by Novo Nordisk for services provided/consultancy and Johnson and Johnson for educational activities. AT reports grants from Novo Nordisk, personal fees from Novo Nordisk, non-financial support from Novo Nordisk, personal fees from Eli Lilly, non-financial support from Eli Lilly, personal fees from Janssen, personal fees from AZ, non-financial support from AZ, non-financial support from Impeto medical, non-financial support from Resmed, non-financial support from Aptiva, personal fees from BI, non-financial support from BI, personal fees from BMS, non-financial support from BMS, personal fees from NAPP, non-financial support from NAPP, personal fees from MSD, non-financial support from MSD, personal fees from Nestle, personal fees from Gilead, grants from Sanofi, and personal fees from Sanofi outside the submitted work. AAT is currently an employee of Novo Nordisk. This work was performed before AAT became a Novo Nordisk employee and Novo Nordisk had no role in this project. KM has been paid honoraria by Ethicon, Medtronic, Gore, Olympus, and various NHS trusts for educational activities and mentoring colleagues through One Anastomosis Gastric Bypass. The other authors declare that they have no conflicts of interest.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

ASJC Scopus subject areas

Medicine (miscellaneous)
Endocrinology, Diabetes and Metabolism
Nutrition and Dietetics

Access to Document

10.1038/s41366-022-01119-x

Post-PrintAccepted author manuscript, 1.16 MB

Cite this

Yang, W., Abbott, S., Borg, C. M., Chesworth, P., Graham, Y., Logue, J., Ogden, J., O’Kane, M., Ratcliffe, D., Sherf-Dagan, S., Singhal, R., Snowdon-Carr, V., Tahrani, A., & Mahawar, K. (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, 46(7), 1341-1350. https://doi.org/10.1038/s41366-022-01119-x

Global variations in preoperative practices concerning patients seeking primary bariatric and metabolic surgery (PACT Study): A survey of 634 bariatric healthcare professionals. / Yang, Wah; Abbott, Sally; Borg, Cynthia Michelle et al.
In: International Journal of Obesity, Vol. 46, No. 7, 07.2022, p. 1341-1350.

Research output: Contribution to journal › Article › peer-review

Yang, W, Abbott, S, Borg, CM, Chesworth, P, Graham, Y, Logue, J, Ogden, J, O’Kane, M, Ratcliffe, D, Sherf-Dagan, S, Singhal, R, Snowdon-Carr, V, Tahrani, A & Mahawar, K 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, vol. 46, no. 7, pp. 1341-1350. https://doi.org/10.1038/s41366-022-01119-x

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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.",

author = "Wah Yang and Sally Abbott and Borg, \{Cynthia Michelle\} and Paul Chesworth and Yitka Graham and Jennifer Logue and Jane Ogden and Mary O{\textquoteright}Kane and Denise Ratcliffe and Shiri Sherf-Dagan and Rishi Singhal and Vanessa Snowdon-Carr and Abd Tahrani and Kamal Mahawar",

note = "Copyright {\textcopyright} and Moral Rights are retained by the author(s) and/ or other copyright owners. A copy can be downloaded for personal non-commercial research or study, without prior permission or charge. This item cannot be reproduced or quoted extensively from without first obtaining permission in writing from the copyright holder(s). The content must not be changed in any way or sold commercially in any format or medium without the formal permission of the copyright holders. This document is the author{\textquoteright}s post-print version, incorporating any revisions agreed during the peer-review process. Some differences between the published version and this version may remain and you are advised to consult the published version if you wish to cite from it. ",

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AU - Abbott, Sally

AU - Borg, Cynthia Michelle

AU - Chesworth, Paul

AU - Graham, Yitka

AU - Logue, Jennifer

AU - Ogden, Jane

AU - O’Kane, Mary

AU - Ratcliffe, Denise

AU - Sherf-Dagan, Shiri

AU - Singhal, Rishi

AU - Snowdon-Carr, Vanessa

AU - Tahrani, Abd

AU - Mahawar, Kamal

N1 - Copyright © and Moral Rights are retained by the author(s) and/ or other copyright owners. A copy can be downloaded for personal non-commercial research or study, without prior permission or charge. This item cannot be reproduced or quoted extensively from without first obtaining permission in writing from the copyright holder(s). The content must not be changed in any way or sold commercially in any format or medium without the formal permission of the copyright holders. This document is the author’s post-print version, incorporating any revisions agreed during the peer-review process. Some differences between the published version and this version may remain and you are advised to consult the published version if you wish to cite from it.

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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

Abstract

Bibliographical note

Funding

UN SDGs

ASJC Scopus subject areas

Access to Document

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