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

Skye Marshall, Hannah Mackay, Graeme Rich, Elisabeth Isenring

Research output: Contribution to journalMeeting AbstractResearchpeer-review

Abstract

Background: Although pre- and postoperative support by a multidisciplinary team (MDT) is recommended as best practice, the impact of how this MDT intervention is delivered has not been reviewed.
Objectives: To evaluate the effect of intensive versus standard pre- and postoperative MDT interventions 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 25 eligible publications (n=15 trials; n=1,400 participants in total) which mostly had low to unclear risk of bias. Intensive interventions improved upon standard MDT interventions by providing: lifestyle counselling (n=4 trials), physical activity (n=8 trials), or psychological therapy (n=3 trial); which were delivered as preoperative (n=3 trials), postoperative (n=7 trials), or pre- and postoperative interventions (n=5 trials). No trial which concluded intervention delivery before 6-months post-surgery reported any effect compared with control (n=9 trials). All six trials which commenced or continued intensive MDT intervention past 6-months post-surgery reported significant improvements in weight and or fat loss (n=5 trials), insulin resistance (n=1 trial), depression (n=1 trial), or blood pressure (n=1 trial) compared with control.
Conclusion: This review suggests that to improve weight loss and health following barbaric surgery, intensive multidisciplinary interventions should commence at, or continue past, 6-months post-surgery, in addition to standard pre- and post-operative care.
Original languageEnglish
Article numberO-206
Pages (from-to)231
JournalObesity Surgery
Volume29
Issue numberS5
DOIs
Publication statusPublished - Sep 2019
Event24th International Federation for the Surgery of Obesity and Metabolic Disorders World Congress - Madrid, Spain
Duration: 3 Sep 20197 Sep 2019
Conference number: 24th
https://www.ifso2019.com/

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Bariatric Surgery
Health
Practice Guidelines
Insulin Resistance
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Life Style
Counseling
Weight Loss
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Fats
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Exercise
Depression
Psychology
Blood Pressure
Weights and Measures

Cite this

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title = "Do intensive preoperative and postoperative multidisciplinary interventions impact health-related bariatric surgery outcomes? A systematic review",
abstract = "Background: Although pre- and postoperative support by a multidisciplinary team (MDT) is recommended as best practice, the impact of how this MDT intervention is delivered has not been reviewed.Objectives: To evaluate the effect of intensive versus standard pre- and postoperative MDT interventions 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 25 eligible publications (n=15 trials; n=1,400 participants in total) which mostly had low to unclear risk of bias. Intensive interventions improved upon standard MDT interventions by providing: lifestyle counselling (n=4 trials), physical activity (n=8 trials), or psychological therapy (n=3 trial); which were delivered as preoperative (n=3 trials), postoperative (n=7 trials), or pre- and postoperative interventions (n=5 trials). No trial which concluded intervention delivery before 6-months post-surgery reported any effect compared with control (n=9 trials). All six trials which commenced or continued intensive MDT intervention past 6-months post-surgery reported significant improvements in weight and or fat loss (n=5 trials), insulin resistance (n=1 trial), depression (n=1 trial), or blood pressure (n=1 trial) compared with control.Conclusion: This review suggests that to improve weight loss and health following barbaric surgery, intensive multidisciplinary interventions should commence at, or continue past, 6-months post-surgery, in addition to standard pre- and post-operative care.",
author = "Skye Marshall and Hannah Mackay and Graeme Rich and Elisabeth Isenring",
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Do intensive preoperative and postoperative multidisciplinary interventions impact health-related bariatric surgery outcomes? A systematic review. / Marshall, Skye; Mackay, Hannah; Rich, Graeme; Isenring, Elisabeth.

In: Obesity Surgery, Vol. 29, No. S5, O-206, 09.2019, p. 231.

Research output: Contribution to journalMeeting AbstractResearchpeer-review

TY - JOUR

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

AU - Marshall, Skye

AU - Mackay, Hannah

AU - Rich, Graeme

AU - Isenring, Elisabeth

N1 - Submitted. Awaiting outcome.

PY - 2019/9

Y1 - 2019/9

N2 - Background: Although pre- and postoperative support by a multidisciplinary team (MDT) is recommended as best practice, the impact of how this MDT intervention is delivered has not been reviewed.Objectives: To evaluate the effect of intensive versus standard pre- and postoperative MDT interventions 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 25 eligible publications (n=15 trials; n=1,400 participants in total) which mostly had low to unclear risk of bias. Intensive interventions improved upon standard MDT interventions by providing: lifestyle counselling (n=4 trials), physical activity (n=8 trials), or psychological therapy (n=3 trial); which were delivered as preoperative (n=3 trials), postoperative (n=7 trials), or pre- and postoperative interventions (n=5 trials). No trial which concluded intervention delivery before 6-months post-surgery reported any effect compared with control (n=9 trials). All six trials which commenced or continued intensive MDT intervention past 6-months post-surgery reported significant improvements in weight and or fat loss (n=5 trials), insulin resistance (n=1 trial), depression (n=1 trial), or blood pressure (n=1 trial) compared with control.Conclusion: This review suggests that to improve weight loss and health following barbaric surgery, intensive multidisciplinary interventions should commence at, or continue past, 6-months post-surgery, in addition to standard pre- and post-operative care.

AB - Background: Although pre- and postoperative support by a multidisciplinary team (MDT) is recommended as best practice, the impact of how this MDT intervention is delivered has not been reviewed.Objectives: To evaluate the effect of intensive versus standard pre- and postoperative MDT interventions 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 25 eligible publications (n=15 trials; n=1,400 participants in total) which mostly had low to unclear risk of bias. Intensive interventions improved upon standard MDT interventions by providing: lifestyle counselling (n=4 trials), physical activity (n=8 trials), or psychological therapy (n=3 trial); which were delivered as preoperative (n=3 trials), postoperative (n=7 trials), or pre- and postoperative interventions (n=5 trials). No trial which concluded intervention delivery before 6-months post-surgery reported any effect compared with control (n=9 trials). All six trials which commenced or continued intensive MDT intervention past 6-months post-surgery reported significant improvements in weight and or fat loss (n=5 trials), insulin resistance (n=1 trial), depression (n=1 trial), or blood pressure (n=1 trial) compared with control.Conclusion: This review suggests that to improve weight loss and health following barbaric surgery, intensive multidisciplinary interventions should commence at, or continue past, 6-months post-surgery, in addition to standard pre- and post-operative care.

U2 - 10.1007%2Fs11695-019-04101-1

DO - 10.1007%2Fs11695-019-04101-1

M3 - Meeting Abstract

VL - 29

SP - 231

JO - Obesity Surgery

JF - Obesity Surgery

SN - 0960-8923

IS - S5

M1 - O-206

ER -