Transferring Postbariatric Patients to Primary Care: A Regionwide Analysis

Background: The provision of a postbariatric multidisciplinary long-term follow-up is recommended, however challenging. Methods: Multidisciplinary teams of two centers, a multi-institutional center for diagnostics and representatives of general practitioners in a Dutch metropole region composed a transmural protocol for transferring bariatric patients 2 years postoperatively to primary care. The quality of these transfers was measured by medical outcomes, quality of life, satisfaction, laboratory results, and re-referrals. Results: Two hundred twenty-two patients were referred according to protocol of which 150 patients were sent beyond 5 years postbariatric. For 11 patients the outcomes were not provided, 3 untraceable, and 11 no-shows, leaving a total of 47 patients for evaluation. Laboratory results were discussed in 32 patients, the psychologic screening questionnaire in 7 patients. It led to referral to the obesity center in six and to additional psychological treatment in four cases. The average satisfaction was graded 6.8. Conclusions: A disappointing low portion of patients was referred to primary care still resulting in an incomplete follow-up. The composition of a transmural protocol by all caretakers did increase the first-level knowledge. The authors assume that this is beneficial for long-term referrals; however, obesity teams should focus on adherence in the first 5 years at a bariatric center.