Primary Care Physicians’ Knowledge, Attitude, and Potential Referral Barriers towards Bariatric Surgery: A Northern Saudi Study

Abstract

Introduction: Bariatric surgery is the most effective procedure for sustained weight loss and control of obesity-associated comorbidities among morbidly obese patients. Successful bariatric surgery depends on a multidisciplinary approach involving all healthcare workers, including the primary care physicians, from the referral of patients to long-term follow-up. The present study assessed the knowledge, attitude, and potential referral barriers of primary care physicians to bariatric surgery and associated sociodemographic factors. Materials and methods: The present analytical cross-sectional study was conducted among 280 randomly selected primary care physicians using a standard and validated data collection tool. We performed an independent t-test and one-way ANOVA to find the association between sociodemographic characteristics and knowledge, attitude, and referral barrier scores. Furthermore, multilinear regression analysis was executed to determine the association among knowledge, attitude, and barriers. Results: The current study found that 52.9%, 19.3%, and 59.3% had a low score in the knowledge, attitude, and barriers categories. The attitude scores were significantly associated with the education status (p = 0.005) and current position at primary health centers (p = 0.012), and the referral barriers score was significantly associated with the work experience duration (p = 0.004). We found a positive relationship between knowledge and attitude (regression coefficient (β) [95% CI]:0.389 [0.154 to 0.585], p = 0.001) and a negative relationship between knowledge and referral barriers (β [95% CI]: −0.291 [−0.127 to −0.058], p = 0.007). Conclusions: Our survey findings suggest that a lack of knowledge regarding bariatric surgery led to several concerns and referral barriers among the physicians. Therefore, the recommendation is to improve the primary care physicians’ knowledge through continuing medical education, symposium, and other suitable training methods with a special focus on obesity care in the curriculum. Furthermore, a mixed-method survey involving other provinces of the KSA is warranted to formulate the region-specific training needs.

Need of a specialised care unit for patients with morbid obesity

“…Por estas razones, el tratamiento de la obesidad debería abarcar diferentes especialidades médicas y quirúrgicas, incluyendo a los médicos de atención primaria, a los especialistas en medicina interna, endocrinología, nutrición, psicología, cirugía bariátrica y a otros profesionales de la salud como los nutricionistas, los fisioterapeutas y los psicólogos. Los médicos de atención primaria y los especialistas en medicina interna son a menudo los primeros profesionales de la salud que ven a pacientes con obesidad y pueden desempeñar un papel importante en la identificación temprana, el diagnóstico y la gestión de la obesidad 6 . Este primer filtro puede proporcionar asesoramiento sobre cambios en el estilo de vida y remitir los pacientes a otros profesionales de la salud según sea necesario, visto que para los especialistas que se dedican exclusivamente a la obesidad puede ser imposible abarcar todo el volumen de pacientes que una pandemia de tal magnitud genera.…”