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The Impact of Educational Handouts on the Compliance Rate for Bariatric Patient Follow-Up Appointments
Nicolas Fedirko1, Kristi Jo Wilson, Roxanne Buterakos
1Author Affiliations: EPIC Health, Southfield, Michigan (Dr Fedirko); Faculty, University of Michigan-Flint, (Drs Wilson and Buterakos), and Munson Healthcare, Traverse City, Michigan (Dr Pechta).
Background And Objectives:
Compliance rates for follow-up appointments are an issue for postoperative sleeve gastrectomy (SG) patients. Without consistent reinforcement and monitoring of patient progress, patients tend to gain the weight back, all of the medical improvements made are lost, and the ability to access patients for potential complications is denied. Patients need much reinforcement during their forever bariatric lifestyle, and the lack of consistent reminders may contribute to follow-up noncompliance and recidivism in SG patients. As time progresses, the follow-up appointment compliance rate decreases. Decreased follow-up can lead to a higher risk for complications such as asymptomatic esophagitis, and current recommendations suggest that esophagogastroduodenoscopy screening should occur 3 years postoperatively. After 1 year, the follow-up compliance decreases dramatically so that by the 3-year postoperative period, very few patients are being seen and scheduled for interventions such as an esophagogastroduodenoscopy. The objective of this quality improvement project was to evaluate the effectiveness of a patient educational handout on SG bariatric patient follow-up visit compliance.
Methods:
A quasi-experimental design and retrospective chart review was chosen. An educational handout was developed. Preintervention retrospective chart review consisted of 441 SG patients expecting a follow-up in 12 to 48 months. Postintervention included 3 months of the handout intervention with data collection totaling 198 patients.
Results:
Follow-up compliance for 4 year visits noted 0% preintervention/12.2% postintervention ( P = .008), for 3 year visits 13.4% preintervention/12% postintervention ( P = .846), for 2 year visits 26.3% preintervention/28.6% postintervention ( P = .755), for 18 months visits 26.3% preintervention/32.6% postintervention ( P = .365), and for 12 months visits 54.2% preintervention/34.1% postintervention ( P = .011).
Conclusions:
In this quality improvement project, educational handouts did not have a statistical impact on follow-up compliance.
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