Objectives: Bariatric surgery is currently one of the most effective management options for patients with morbid obesity, aiming to reduce the risks of multiple comorbidities and improve cost-efficiency. A local audit was performed to compare the current practice at a general practice clinic in line with the British Obesity & Metabolic Surgery Society (BOMSS) guidelines, which have published recommended guidelines for post-operative care and monitoring upon discharge from the bariatric centre.
Methods: A general practice database in Oxford was searched to identify patients registered as active members of the practice with a history of bariatric surgery. Data on the patient demographics, which surgical procedure they received (laparoscopic adjustable gastric bypass (LAGB), Roux-en-Y bypass, or sleeve gastrectomy), and what follow-up tests and prescriptions they were receiving in line with the BOMSS guidelines were collated.
Results: 9 patients in total were identified, 4 with a LAGB, 3 with a sleeve gastrectomy, and 2 with a Roux-en-Y bypass. None of the patients had been seen 1 year after discharge from the bariatric service by a general practitioner. 4 of the 5 patients eligible for B12 injections were regularly receiving treatment, and 2 of those patients were receiving regular blood tests alongside. 5 of the patients were receiving repeat dispensing prescriptions of calcium and/or multivitamins.
Conclusion: There is currently a lack of adequate follow-up upon discharge from the bariatric service. Education and reminders of how and what follow-up is required should be provided for all members of the practice, as well as clear communication between the bariatric and primary care service teams, to provide a better flow of care for bariatric patients and prevent further complications.