S157-a structured early intervention program in patients with predicted poor long-term outcome following bariatric surgery: a prospective randomized study.

BACKGROUND: Early postoperative weight loss can be predictive of one-year outcomes. It is unclear if poor performers identified in the first post-operative month can have improvement in outcomes with additional support and education. PURPOSE: To evaluate the impact of a structured targeted support program for patients with lower-than-average early post-operative weight loss on 1-year outcomes. METHODS: This was a prospective randomized study of bariatric surgery patients who experienced less than 50th percentile excess body weight loss (%EWL) at 3 weeks. Subjects with EWL < 18% were randomized into two groups: an intervention (IV) arm or a control (NI, no intervention) arm. The IV arm was offered a program with 7-weekly behavioral support sessions, while the NI patients received routine post-operative care. RESULTS: A total of 128 patients were randomized: 65 NI and 63 IV. In the IV group, 20 attended all sessions, 7 attended < 4, and 36 did not participate. There was no difference in baseline demographics, procedure type, or BMI. At 1 year, there was no difference in %EWL (ratio 0.993, 95% CI 0.873, 1.131), %EBMIL (ratio 0.997, 95% CI 0.875, 1.137), and %TWL (ratio 1.016, 95% CI 0.901, 1.146) between groups. A subgroup analysis including only the subjects who participated in all seven sessions showed similar results. CONCLUSION: Patients who present with suboptimal weight loss early after bariatric surgery do not experience a significant weight loss improvement with a structured behavioral support program. Importantly, despite being alerted to their poor early weight loss, patients demonstrated poor adherence to the proposed interventions.

Readability of Online Patient Material Provided by Reflux Centers in the United States.

The American Medical Association (AMA) and the National Institutes of Health (NIH) suggest patient education materials should not exceed the sixth-grade reading level. Several studies have shown that patient information has been written well above this reading level across multiple specialties. A search was conducted utilizing the Google Chrome browser and the Google search engine. The key words "Reflux Center" and "GERD Center" were used to identify links to programs within the United States. The web site's general description of reflux or gastroesophageal reflux disease was copied and pasted into the Readable.io service, and the readability tests were conducted via the program. Of 52 web sites, none had fulfilled the recommended reading level. Our results reveal that readability related to reflux pathology on center web sites is too difficult for the average patient. In order to improve patient education regarding reflux pathology and treatment, reading materials should be improved.