Promise Care is a NIHR funded study that aims to improve the care of patients who have had bariatric surgery
What is the problem?
Scientific studies have shown the benefits of weight-loss surgery. However, people who have had weight-loss surgery can regain weight, struggle with excess skin and/or develop low vitamins and nutrients levels, which can have serious effects on health and wellbeing. Weight-loss surgery patients can have a complex mixture of physical and psychological health needs that require careful monitoring after surgery.
Guidance recommends that patients are reviewed by their surgical team for 2 years after surgery and then have yearly GP reviews. However, research suggests these yearly reviews are not happening. This is concerning as patients who do not receive follow-up have worse health outcomes.
We know that GPs are not confident in caring for weight-loss surgery patients, and that patients want more support. We plan to develop and test a package of care to support weight-loss surgery patients, but before we can do this we need to do some developmental work to inform this future study.
It's not clear how or who would be best to give this long-term care, or how patients would prefer to receive it. There are also difficulties in deciding what this care should look like, including variation in existing weight management services, primary/secondary care capacity issues and variable patient needs.
Promise Care study aims
To understand the issues relating to high quality long-term care following weight-loss surgery from the perspectives of patients, healthcare professionals and commissioners. This will help us decide what should be included in the package of long-term care for weight-loss surgery patients.
Promise Care study plans
First, we will interview healthcare professionals as we currently do not have any detailed information on their views. Then we will hold three discussion events using system mapping. This is a process that allows us to gather information to produce a visual map (like a mind map or spider diagram) that shows all the issues related to delivering this care and what affects them, from the perspectives of patient stakeholders and professional groups. After this 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 to see if it works.
Involvement of patients and public in the Promise Care study
People who have had weight-loss surgery have shared their experiences and helped develop this project in a way that might address the problems that they have experienced. The research team includes a co-investigator with direct experience of weight-loss surgery. We will continue to work with a group of patient/public contributors throughout this research.
Anticipated outcomes from the Promise Care study
Once this work is completed, we will be able to design and deliver a larger project to develop and test a package of care for long-term follow-up of weight-loss surgery patients. We will share our findings with patient groups, NHS clinicians, commissioners and policy makers.
Contact the Promise Care study team: promise.care@uea.ac.uk
This study is funded by the NIHR Programme Development Grant (NIHR 204217). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.