An Initial Test of the Efficacy of a Digital Health Intervention for Bariatric Surgery Candidates

Sysko, Robyn; Michaelides, Andreas; Costello, Kayla; Herron, Daniel M.; Hildebrandt, Tom

doi:10.1007/s11695-022-06258-8

Cited by 5 publications

(3 citation statements)

References 43 publications

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“…The other three apps were aimed at engagement and stimulation of physical activity and a healthy diet of bariatric patients [35][36][37]. The extensive app of Sysko et al was provided in combination with eight weekly virtual check-ins to review weight loss and the overall process before bariatric surgery [35]. The app was evaluated in a pilot RCT.…”

Section: Weight Lossmentioning

confidence: 99%

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Mobile applications in gastrointestinal surgery: a systematic review

et al. 2023

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Background Mobile applications can facilitate or improve gastrointestinal surgical care by benefiting patients, healthcare providers, or both. The extent to which applications are currently in use in gastrointestinal surgical care is largely unknown, as reported in literature. This systematic review was conducted to provide an overview of the available gastrointestinal surgical applications and evaluate their prospects for surgical care provision. Methods The PubMed, EMBASE and Cochrane databases were searched for articles up to October 6th 2022. Articles were considered eligible if they assessed or described mobile applications used in a gastrointestinal surgery setting for healthcare purposes. Two authors independently evaluated selected studies and extracted data for analysis. Descriptive data analysis was conducted. The revised Cochrane risk of bias (RoB-2) tool and ROBINS-I assessment tool were used to determine the methodological quality of studies. Results Thirty-eight articles describing twenty-nine applications were included. The applications were classified into seven categories: monitoring, weight loss, postoperative recovery, education, communication, prognosis, and clinical decision-making. Most applications were reported for colorectal surgery, half of which focused on monitoring. Overall, a low-quality evidence was found. Most applications have only been evaluated on their usability or feasibility but not on the proposed clinical benefits. Studies with high quality evidence were identified in the areas of colorectal (2), hepatopancreatobiliary (1) and bariatric surgery (1), reporting significantly positive outcomes in terms of postoperative recovery, complications and weight loss. Conclusions The interest for applications and their use in gastrointestinal surgery is increasing. From our study, it appears that most studies using applications fail to report adequate clinical evaluation, and do not provide evidence on the effectiveness or safety of applications. Clinical evaluation of objective outcomes is much needed to evaluate the efficacy, quality and safety of applications being used as a medical device across user groups and settings.

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Section: Weight Lossmentioning

confidence: 99%

“…Four apps intended to improve postoperative recovery, providing perioperative information and feedback on the postoperative recovery process [34][35][36][37][38][39][40]. The app "IkHerstel" (I recover) was initially developed for gynecological patients and adapted to fit a general gastrointestinal surgical population [38].…”

Section: Postoperative Recoverymentioning

confidence: 99%

Mobile applications in gastrointestinal surgery: a systematic review

et al. 2023

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“…Mobile health (mHealth), including smartphone applications (apps), has become a popular platform for delivering health services since the COVID-19 pandemic [ 20 – 24 ]. mHealth interventions as tools for the education and engagement of patients before bariatric surgery seem promising [ 25 , 26 ]. Nevertheless, there is limited evidence regarding its effectiveness in the postoperative FU phase.…”

Section: Introductionmentioning

confidence: 99%

Remote Follow-up with a Mobile Application Is Equal to Traditional Outpatient Follow-up After Bariatric Surgery: the BELLA Pilot Trial

et al. 2023

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Purpose Medical follow-up after bariatric surgery is recommended. However, the compliance was poor. This study aimed to evaluate the feasibility of a smartphone-based fully remote follow-up (FU) program for patients after bariatric surgery. Methods In the interventional group, patients were followed up using a smartphone application (app), through which questionnaires were sent regularly. Participants in the control group underwent standard FU at the outpatient clinic every three months. After 12 months, all the participants were evaluated at an outpatient clinic. Results Between August 2020 and March 2021, 44 and 43 patients in the interventional and control groups, respectively, were included in the analysis after three patients were lost to FU, and three withdrew their informed consent because they wished for more personal contact with medical caregivers. After 12 months, total weight loss (TWL), %TWL, and percentage of excess weight loss (%EWL) did not differ between groups. There were no significant differences in the complication rates, including surgical complications, malnutrition, and micronutrition deficiency. The parameters of bioelectrical impedance analysis and quality of life did not differ between the groups. Vitamins and minerals in serum were similar in both groups except for calcium, which was significantly higher in the interventional group (2.52 mmol/L vs. 2.35 mmol/L, p = 0.038). Conclusion Fully remote FU with a smartphone application is at least as effective as traditional in-person FU in an outpatient clinic after bariatric surgery. Through remote FU, patients can save time and medical professionals may have more resources for patients with more severe problems. Graphical Abstract

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