Do intensive preoperative and postoperative behavioural interventions impact on health-related bariatric surgery outcomes? A systematic review

Skye Marshall, Hannah Mackay, Graeme Rich, Elisabeth Isenring

Research output: Contribution to journalMeeting AbstractResearchpeer-review

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Abstract

Rationale: Although pre- and postoperative support by a multidisciplinary team (MDT) is recommended as best practice, it is unknown if intensive behavioural interventions improve outcomes beyond standard MDT support. This systematic review aimed to evaluate the effect that intensive pre- and postoperative behavioural interventions have on health-related outcomes post-surgery in adult bariatric surgery patients.
Methods: Six databases were searched for intervention studies in any language up until July 2018. Study quality was assessed using the Cochrane Risk of Bias tool.
Results: 6,871 records were screened, identifying 17 eligible publications (n=10 trials; n=1,169 participants in total) which mostly had low to unclear risk of bias. Intensive behavioural interventions addressed lifestyle (n=4 trials), physical activity (n=3 trials), or cognitive behavioural therapy (n=3 trial); which were delivered as preoperative interventions (n=3 trials), postoperative interventions (n=2 trials), or pre- and postoperative intervention (n=5 trials). Intensive interventions varied from weekly to quarterly in frequency, with a duration from 6-weeks to 24-months. No trial which concluded intervention delivery before 6-months post-surgery reported any effect compared with control (n=6 trials). All six trials which commenced or continued MDT delivery 6-months post-surgery reported significant improvements in weight and/or fat loss (n=4 trials) and depression (n=1 trial) compared with control.
Conclusions: For the best outcomes and most efficacious use of resources, intensive multidisciplinary behavioural interventions may be of the greatest value if they commence 6-months postoperatively; with standard multidisciplinary support provided pre- and early postoperatively.
Original languageEnglish
Article numberMON-PO580
Pages (from-to)s274
JournalClinical Nutrition
Volume38
Issue numberS1
DOIs
Publication statusPublished - Sep 2019
Event41st ESPEN Congress: on Clinical Nutrition and Metabolism - Krakow, Poland
Duration: 31 Aug 20193 Sep 2019
https://espencongress.com/

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Cite this

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title = "Do intensive preoperative and postoperative behavioural interventions impact on health-related bariatric surgery outcomes? A systematic review",
abstract = "Rationale: Although pre- and postoperative support by a multidisciplinary team (MDT) is recommended as best practice, it is unknown if intensive behavioural interventions improve outcomes beyond standard MDT support. This systematic review aimed to evaluate the effect that intensive pre- and postoperative behavioural interventions have on health-related outcomes post-surgery in adult bariatric surgery patients.Methods: Six databases were searched for intervention studies in any language up until July 2018. Study quality was assessed using the Cochrane Risk of Bias tool.Results: 6,871 records were screened, identifying 17 eligible publications (n=10 trials; n=1,169 participants in total) which mostly had low to unclear risk of bias. Intensive behavioural interventions addressed lifestyle (n=4 trials), physical activity (n=3 trials), or cognitive behavioural therapy (n=3 trial); which were delivered as preoperative interventions (n=3 trials), postoperative interventions (n=2 trials), or pre- and postoperative intervention (n=5 trials). Intensive interventions varied from weekly to quarterly in frequency, with a duration from 6-weeks to 24-months. No trial which concluded intervention delivery before 6-months post-surgery reported any effect compared with control (n=6 trials). All six trials which commenced or continued MDT delivery 6-months post-surgery reported significant improvements in weight and/or fat loss (n=4 trials) and depression (n=1 trial) compared with control.Conclusions: For the best outcomes and most efficacious use of resources, intensive multidisciplinary behavioural interventions may be of the greatest value if they commence 6-months postoperatively; with standard multidisciplinary support provided pre- and early postoperatively.",
author = "Skye Marshall and Hannah Mackay and Graeme Rich and Elisabeth Isenring",
year = "2019",
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doi = "10.1016/S0261-5614(19)32413-6",
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Do intensive preoperative and postoperative behavioural interventions impact on health-related bariatric surgery outcomes? A systematic review. / Marshall, Skye; Mackay, Hannah; Rich, Graeme; Isenring, Elisabeth.

In: Clinical Nutrition, Vol. 38, No. S1, MON-PO580, 09.2019, p. s274.

Research output: Contribution to journalMeeting AbstractResearchpeer-review

TY - JOUR

T1 - Do intensive preoperative and postoperative behavioural interventions impact on health-related bariatric surgery outcomes? A systematic review

AU - Marshall, Skye

AU - Mackay, Hannah

AU - Rich, Graeme

AU - Isenring, Elisabeth

PY - 2019/9

Y1 - 2019/9

N2 - Rationale: Although pre- and postoperative support by a multidisciplinary team (MDT) is recommended as best practice, it is unknown if intensive behavioural interventions improve outcomes beyond standard MDT support. This systematic review aimed to evaluate the effect that intensive pre- and postoperative behavioural interventions have on health-related outcomes post-surgery in adult bariatric surgery patients.Methods: Six databases were searched for intervention studies in any language up until July 2018. Study quality was assessed using the Cochrane Risk of Bias tool.Results: 6,871 records were screened, identifying 17 eligible publications (n=10 trials; n=1,169 participants in total) which mostly had low to unclear risk of bias. Intensive behavioural interventions addressed lifestyle (n=4 trials), physical activity (n=3 trials), or cognitive behavioural therapy (n=3 trial); which were delivered as preoperative interventions (n=3 trials), postoperative interventions (n=2 trials), or pre- and postoperative intervention (n=5 trials). Intensive interventions varied from weekly to quarterly in frequency, with a duration from 6-weeks to 24-months. No trial which concluded intervention delivery before 6-months post-surgery reported any effect compared with control (n=6 trials). All six trials which commenced or continued MDT delivery 6-months post-surgery reported significant improvements in weight and/or fat loss (n=4 trials) and depression (n=1 trial) compared with control.Conclusions: For the best outcomes and most efficacious use of resources, intensive multidisciplinary behavioural interventions may be of the greatest value if they commence 6-months postoperatively; with standard multidisciplinary support provided pre- and early postoperatively.

AB - Rationale: Although pre- and postoperative support by a multidisciplinary team (MDT) is recommended as best practice, it is unknown if intensive behavioural interventions improve outcomes beyond standard MDT support. This systematic review aimed to evaluate the effect that intensive pre- and postoperative behavioural interventions have on health-related outcomes post-surgery in adult bariatric surgery patients.Methods: Six databases were searched for intervention studies in any language up until July 2018. Study quality was assessed using the Cochrane Risk of Bias tool.Results: 6,871 records were screened, identifying 17 eligible publications (n=10 trials; n=1,169 participants in total) which mostly had low to unclear risk of bias. Intensive behavioural interventions addressed lifestyle (n=4 trials), physical activity (n=3 trials), or cognitive behavioural therapy (n=3 trial); which were delivered as preoperative interventions (n=3 trials), postoperative interventions (n=2 trials), or pre- and postoperative intervention (n=5 trials). Intensive interventions varied from weekly to quarterly in frequency, with a duration from 6-weeks to 24-months. No trial which concluded intervention delivery before 6-months post-surgery reported any effect compared with control (n=6 trials). All six trials which commenced or continued MDT delivery 6-months post-surgery reported significant improvements in weight and/or fat loss (n=4 trials) and depression (n=1 trial) compared with control.Conclusions: For the best outcomes and most efficacious use of resources, intensive multidisciplinary behavioural interventions may be of the greatest value if they commence 6-months postoperatively; with standard multidisciplinary support provided pre- and early postoperatively.

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DO - 10.1016/S0261-5614(19)32413-6

M3 - Meeting Abstract

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SP - s274

JO - Clinical Nutrition

JF - Clinical Nutrition

SN - 0261-5614

IS - S1

M1 - MON-PO580

ER -