Pre-post changes of integrated care needs in patients undergoing bariatric surgery

Patients undergoing bariatric surgery have complex bio-psycho-social needs which require integrated care. This study aimed to evaluate changes of integrated care needs from pre- to one-year post-surgery and to identify baseline variables associated with integrated care needs at follow-up.

A retrospective cohort study analyzed routinely collected data from a questionnaire-based psychosocial screening conducted prior to evaluation for bariatric surgery and annual follow-up. Integrated care needs were assessed using the INTERMED self-assessment questionnaire (IM-SA), which assesses care needs of four domains (biological, psychological, social, healthcare-related) and identifies patients with case complexity (total score ≥19). Multiple regression analysis examined associations between baseline variables and integrated care needs at follow-up.

Out of 225 patients who were screened and underwent bariatric surgery between June 2020 and June 2022, 117 provided both pre- and one-year postsurgical data (52%) and thus were included in the study. At one-year post-surgery, integrated care needs were reduced (p < 0.001) and the proportion of patients with case complexity decreased (10.3% vs. 24.8%, p < 0.001). IM-SA scores were reduced in all domains - except the social domain. Sick leave (β = 0.172, p = 0.030) and symptoms of anxiety at baseline (β = 0.235, p = 0.018) were associated with integrated care needs at follow-up.

Bio-psycho-social care needs should be evaluated in pre- and post-bariatric surgery care through a structured assessment, social workers included in the multidisciplinary team, and patients offered psychosocial support prior and after surgery. Rethinking the role and training of social workers is essential, along with developing innovative social interventions extending beyond traditional support.