Application and effectiveness of eHealth strategies for metabolic and bariatric surgery patients: A systematic review

Abstract

Objective: To date the application of eHealth strategies among adults and adolescents undergoing metabolic and bariatric surgery (MBS) has not been systematically reviewed. This study comprehensively examines eHealth intervention studies among MBS patients within the RE-AIM framework to assess reach, effectiveness, adoption, implementation and maintenance of these efforts.Methods: A search was conducted using PubMed, EMBASE, CINAHL, PsycNET and SCOPUS of original research relating to eHealth strategies for MBS patients published in peer-reviewed journals and revealed 38 published articles between 2011 and 2019.Results: Studies varied widely in terms of design (qualitative to randomized controlled trials) and eHealth delivery method (telemedicine to blog post content) with a balance of pre-or post-MBS use. No studies included adolescents and very few reported (1) a conceptual framework to support study design/outcomes; and (2) race/ethnicity composition. Conclusions:Although some studies report that eHealth strategies/interventions are effective in producing post-MBS weight loss and other positive health outcomes, most are pilot studies or have study design limitations. There is an opportunity for development of (1) tailored eHealth interventions to support pre-and post-MBS sustained behavior change and improved outcomes; and (2) rigorous studies that employ robust conceptual frameworks so dissemination and implementation efforts can be mapped to construct-driven outcomes.

Telemedicine Implementation on a Bariatric Outpatient Clinic During COVID-19 Pandemic in Italy: an Unexpected Hill-Start

“…Telemedicine offers clear opportunities to abolish barriers of distance and to save time and direct costs. Also, in the field of bariatric surgery, there is a growing interest in the application of e-health systems in the pre-and postoperative period [9]. In the context of the COVID-19 pandemic, facilitating healthcare access by maintaining strict individual protection provisions became a priority to ensure safety for patients and healthcare professionals, and to allow the continuation of specialist medical services.…”

“…Messiah et al [9], in a recent review of eHealth strategies for metabolic and bariatric surgery patients, analyzed 38 published articles between 2011 and 2019 that varied widely in terms of study design and presented several limitations. Despite this, the authors reported overall positive results in terms of feasibility, acceptability, and preliminary effectiveness of eHealth delivery of pre-and postoperative educational materials, knowledge exchange, and social support.…”

The Impact of Coronavirus Disease 2019 on Bariatric Surgery: Redefining Psychosocial Care

“…Although the evidence for mobile and online technologies (e‐health) in obesity and bariatric care is still in its infancy, there is emerging evidence that these e‐health tools are acceptable to patients, have the potential for significant reach, and demonstrate efficacy for psychological symptoms and eating psychopathology (14). The rapid implementation of virtual care during COVID‐19 will offer greater research opportunities for improving our understanding of e‐health effectiveness in youth populations, long‐term outcomes (including weight loss), key implementation factors, and patient response.…”

Emotional Resilience and Bariatric Surgical Teams: a Priority in the Pandemic

“…A systematic review of studies examining eHealth pre- and post-operatively in bariatric surgical programmes found variation in study design, methodologies and method of eHealth delivery across the 38 studies. Although there was evidence of weight loss and other positive health outcomes, many of the studies were pilot and had acknowledged limitations [ 25 ]. The review was published pre-pandemic, which may not reflect the current situation and increased the use of eHealth technologies.…”