PROMISE CARE STUDY

  • Research type

    Research Study

  • Full title

    Improving the long-term care of patients who have had bariatric surgery: PROMISE CARE study

  • IRAS ID

    320028

  • Contact name

    Helen M Parretti

  • Contact email

    h.parretti@uea.ac.uk

  • Sponsor organisation

    University of East Anglia

  • Duration of Study in the UK

    1 years, 5 months, 30 days

  • Research summary

    Summary of Research

    Studies have shown the benefits of weight-loss surgery (WLS). However, people who have had WLS can have physical and psychological health needs that require careful monitoring post-surgery.

    Guidance recommends patients are reviewed by their surgical team for 2yrs and then have yearly GP reviews. However, research suggests these GP reviews are not happening. We know that many GPs are not confident in caring for patients post-WLS, and patients want more support. We plan to develop and test a package of care for patients post-WLS, but before we can do this we need to do some developmental work to inform this future study. It is not clear who would be best to give this long-term care, or how patients would prefer to receive it. There are difficulties in deciding what this care should look like, including variation in weight management services, GP/hospital capacity and variable patient needs.

    This study aims to understand the issues relating to long-term care following WLS from the perspectives of key stakeholders to help us decide what should be included in the package of long-term care for patients post-WLS.

    We will interview healthcare professionals as there is not yet any detailed information from research on their views. Then we will hold three discussion meetings using “system mapping”, a process that allows us to gather information to produce a diagram (like a mind map/spider diagram) showing the issues related to post-WLS care and what affects them, from the perspectives of stakeholders.

    Finally, we will meet with stakeholders again to discuss the “map” and agree what type and format of intervention to develop and test in a larger research study.

    WLS patients have helped develop this project. We will continue to engage with patient/public contributors throughout this research. We will share our findings with patients, clinicians, commissioners and policy makers.

    Summary of Results

    Background Weight-loss surgery (WLS) benefits health, but can result in long-term problems. Guidance recommends reviews by the surgical team for 2yrs after surgery and then yearly GP reviews. However, research suggests these GP reviews are not happening.
    Aims and objectives
    We want to develop and test a package of care to support WLS patients, but needed to understand better the issues in giving this care.
    Methods
    We interviewed primary care and specialist weight management healthcare professionals (HCPs) to explore experiences/views on long-term care after WLS. Then we held three workshops with patients, HCPs and NHS commissioners. These used “system mapping”, a process that allows us to gather information to produce a visual map that shows all the issues related to delivering post-surgical care. We met with participants again to discuss the system map and identify possible interventions.
    Key findings
    Our analysis revealed ten themes relating to providing long-term WLS follow-up care. The system map showed the complexity of long-term follow-up support after WLS. Stakeholders identified ten key elements (for example, minimum requirements for services) that should be considered in a future package of care.
    Dissemination, outputs and impact
    This research has been presented at two academic meetings. We also plan to present the system map at future meetings and publish two academic papers. We plan to share findings with the public, patient groups, clinicians, commissioners and policy makers.
    Patient and public involvement (PPIE)
    Four people and our PPIE co-investigator who have had WLS shared their views throughout the research. Their input was key to the system mapping workshops.
    Conclusions and future plans
    We have gained a good understanding of the issues around providing long-term care after WLS, which will help develop and evaluate a programme for long-term care after WLS.

  • REC name

    North East - Newcastle & North Tyneside 1 Research Ethics Committee

  • REC reference

    23/NE/0039

  • Date of REC Opinion

    21 Feb 2023

  • REC opinion

    Further Information Favourable Opinion