Follow-Up, Safety, and Satisfaction with Tele-bariatric Follow-Up Implemented During the COVID-19 French Lockdown: a 2-Year Follow-Up Study

Expert Opinion on the Utility of Telemedicine in Obesity Care: Recommendations on a Hybrid Multidisciplinary Integrated Care Follow-Up Algorithm

PURPOSE OF REVIEW

The proposed expert opinion was prepared by a panel of obesity and law specialists from Turkey to review the utility of telemedicine in obesity care and to provide a guidance document with recommendations on a hybrid multidisciplinary integrated care follow-up algorithm and the legislation governing telemedicine practice to assist obesity specialists in practicing the telemedicine.

RECENT FINDINGS

The efficacy and feasibility of telemedicine interventions in supporting obesity management programs even during pandemics confirm that obesity is a particularly well-suited field for telemedicine, emphasizing the strong likelihood of continued utilization of telemedicine in obesity management, beyond the pandemic period. Telemedicine has great potential to address several barriers to ongoing weight-management care, such as challenges of access to specialized care, cost, and time limitations as well as patient adherence to treatment. However, telemedicine practice should complement rather than replace the in-person visits which are unique in building rapport and offering social support. Accordingly, the participating experts recommend the use of a hybrid integrated care model in the management of obesity, with the use of telemedicine, as an adjunct to in-person visits, to enable the provision of suggested intensive obesity management via frequent visits by a multidisciplinary team of obesity specialists. Further research addressing the utility of telemedicine in terms of optimal modality and duration for successful long-term obesity management outcomes is necessary to develop specific guidelines on telemedicine practice. In addition, the legislation governing the norms and protocols on confidentiality, privacy, access, and liability needs to be improved.

The development of evaluation scale of the patient satisfaction with telemedicine: a systematic review

BACKGROUND

Since the outbreak of the COVID-19 pandemic, telemedicine become more and more popular, patients attempt to use telemedicine to meet personal medical needs. Patient satisfaction is a key indicator of insight into the patient experience.

PURPOSE

This systematic review aims to explore the measurement factors of patient satisfaction with telemedicine and develop a more comprehensive and systematic scale of patient satisfaction with telemedicine.

METHODS

In February 2023, a literature search was conducted on the PubMed, EMBASE, and Web of Science, identifying measurement factors and tools of patient satisfaction with telemedicine. For inclusion, the studies had to have or make a questionnaire about patient satisfaction with telemedicine delivered through video/audio visits in English. The quality of the studies was evaluated according to the Critical Appraisal Tool for Analytical Cross-Sectional Studies of the Joanna Briggs Institute (JBI). The dimensions and items in each tool were also analyzed.

RESULTS

The initial search showed 14,020 studies. After eliminating duplicates and utilizing inclusion and exclusion criteria, 44 studies were included. This systematic review identified and integrated the measurement factors and develops a scale of patient satisfaction with telemedicine, which was divided into 9 dimensions and consists of 37 items.

CONCLUSION

Future measurement and evaluation of telemedicine will benefit from scale that was developed in this study, and it will more directly reflecting patient needs when patient satisfaction with telemedicine is evaluated.

Revisional Roux-en-Y Gastric Bypass After Sleeve Gastrectomy for Gastro-esophageal Reflux Disease and or Insufficient Weight-Loss: a Comparative Study

INTRODUCTION

Sleeve gastrectomy (SG) is a popular surgical weight-loss procedure, but there are increasing reports of revisional Roux-Y-gastric-bypass (R-RYGB) to manage weight-loss failure (WLF) or proton pump inhibitor (PPI)-refractory gastroesophageal reflux disease (GERD) after SG, with little data available in these settings.

METHODS

This retrospective study included all consecutive patients undergoing R-RYGB for WLF or RGERD after SG in two bariatric care centers from 2012 to 2018.

RESULTS

Of 720 patients, 46 (3.6%) underwent R-RYGB (RGERD, n = 25; 54.4%; WLF, n = 21; 45.6%) within 44.8 ± 27.5 months post-SG. SG had enabled 27% ± 11.6 total weight loss (TWL) in the RGERD group vs. 7.2% ± 12.5% TWL in the WLF group (p < 0.001). At R-RYGB, WLF-group patients had a higher BMI (47.8 ± 8.4 vs. 34.7 ± 6.1 kg/m2; p < 0.001) and a higher number of comorbidities (2.4 ± 1.5 vs 1.5 ± 1.2; p < 0.02) compared to RGERD-group patients, while severe morbidity (Clavien-Dindo ≥ IIIb) was not significantly different between groups (6.5% vs 2.1%, p = 0.6). %TWL was still higher in the RGERD group at 12 months post-R-RYGB (35.6% ± 10.4 vs. 23.8% ± 9.2; p < 0.01) but not after 24 months post-R-RYGB. R-RYGB corrected reflux symptoms in 32 (94%) patients and reduced PPI use in 29 (97%) patients (p < 0.001), with no significant between-group difference. A history of adjustable gastric banding (AGB) (N = 8;17.4%) prior to SG was associated with a similar prevalence of GERD at R-RYGB and a lower %TWL (AGB:13.1 ± 10.2 vs. No AGB:31.6 ± 8.5; p < 0.05) at 3 years post-R-RYGB.

CONCLUSION

R-RYGB following SG provides remission of reflux symptoms in 94% of patients and extra weight loss in patients with WLF, except in patients with a history of AGB prior to SG.

Precision Bariatric/Metabolic Medicine and Surgery

Indications and techniques of bariatric surgery (BS) have constantly evolved in recent decades and now face new challenges [...].