Greater adherence to treatment after bariatric surgery by the implementation of a standardized protocol for delivering care

Background Bariatric surgery reference centers adopt different postoperative care protocols. Objectives To assess the impact of implementing a standardized postoperative care protocol on patients’ adherence to vitamin and mineral supplementation and to a multidisciplinary team, and on health-related quality-of-life (HRQoL) during the first year after Roux-en-Y gastric bypass (RYGB). Setting: University Hospital, Brazil; Public Practice. Methods This study compared a retrospective cohort [n = 70; usual care (UC)] with a prospective cohort [n = 70; standardized postoperative protocol (SP)], both undergone RYGB. The protocol included pre-scheduled appointments with a multidisciplinary care team, a systematic follow-up through phone calls, and a a standardized free of charge supplementation over one year. Results Mean age was 42.3 ± 10.1 years and preoperative body mass index was 48.8 ± 8.3 kg/m². Adherence to the multidisciplinary team follow-up was 81.7% in the UC and 96.9% in the SP ( p  = .003). The SP group showed higher vitamin D serum levels at 3, 6, and 12 months ( p  < .001). Overall, the percentage of multivitamin, calcium, vitamin D, and vitamin B12 use was remarkably lower in the UC group compared to the SP group, from 30 days to one year postoperative ( p  < .005). At 12 months, the SP group also showed higher scores of general health ( p  < .001) and social functioning ( p  = .004) in HRQoL. Conclusions The standardized, pragmatic postoperative care protocol improved adherence to the postoperative bariatric surgery care, reducing the incidence of hypovitaminosis D and increasing HRQoL one year following bariatric surgery, and could be used as a reference for clinical protocols and therapeutic guidelines in public health systems.