Nutritional monitoring of patients post‐bariatric surgery: implications for smartphone applications

BACKGROUND Optimal results from bariatric surgery are contingent on patient commitment to dietary and lifestyle changes and follow-up care. The present study aimed to investigate the attitudes and use of mobile health (mHealth) smartphone applications (apps) as a potential tool for maintaining connectivity between dietitians and patients post-bariatric surgery. METHODS A cross-sectional online survey was developed and distributed to a purposeful sample of bariatric dietitians and bariatric patients in Australia. The survey questions explored technology penetration (smartphone and app use), communication preferences, nutrition monitoring methods, professional relationship expectations and reasons for loss to follow-up. RESULTS Survey completion rate was 85% (n = 50/59) for dietitians and 80% (n = 39/49) for patients. Smartphone ownership was 98% and 95% for dietitians and patients, respectively. Common reasons given for losing patients to follow-up suggest that a traditional in-clinic practice setting could be a barrier for some. Most dietitians (n = 48; 91%) prefer to see patients face-to-face in their clinic, whereas patient preferences extended to e-mail and mobile messaging. Sixty-eight percent of bariatric patients were receptive to two-way communication with dietitians via an app between clinic visits. Both cohorts recognised the potential for emerging technologies to be used in practice, although there was no single routinely recommended mHealth app. CONCLUSIONS The present study provides the first insight into the use of mobile devices and apps by post-bariatric patients and the dietitians who support them. A mixture of traditional methods and smartphone technology is desirable to both dietitians and patients. The utility and effectiveness of such technologies should be confirmed in future intervention studies.

[1]  A. Madan,et al.  What Happens to Patients who Do Not Follow-Up after Bariatric Surgery? , 2007, The American surgeon.

[2]  E. Segaran Provision of nutritional support to those experiencing complications following bariatric surgery , 2010, Proceedings of the Nutrition Society.

[3]  Albert W Wu,et al.  The Role of Informatics in Promoting Patient-Centered Care , 2011, Cancer journal.

[4]  Susannah Fox,et al.  Mobile health 2012 , 2012 .

[5]  Heather Wharrad,et al.  Smartphone and medical related App use among medical students and junior doctors in the United Kingdom (UK): a regional survey , 2012, BMC Medical Informatics and Decision Making.

[6]  N. Ahuja,et al.  The Smartphone in Medicine: A Review of Current and Potential Use Among Physicians and Students , 2012, Journal of medical Internet research.

[7]  R. Hanning,et al.  Dietary assessment and self-monitoring with nutrition applications for mobile devices. , 2012, Canadian journal of dietetic practice and research : a publication of Dietitians of Canada = Revue canadienne de la pratique et de la recherche en dietetique : une publication des Dietetistes du Canada.

[8]  Jennifer L. Fisher,et al.  Who gives a tweet: assessing patients' interest in the use of social media for health care. , 2012, Worldviews on evidence-based nursing.

[9]  A. Goday,et al.  Lack of Adherence to Follow-Up Visits After Bariatric Surgery: Reasons and Outcome , 2014, Obesity Surgery.

[10]  M. Mcmahon,et al.  Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient--2013 update: cosponsored by American Association of Clinical Endocrinologists, the Obesity Society, and American Society for Metabolic & Bariatric Surgery. , 2013, Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists.

[11]  N. Howes,et al.  Obesity Surgery Smartphone Apps: a Review , 2013, Obesity Surgery.

[12]  C. Shannon,et al.  The bariatric surgery patient--nutrition considerations. , 2013, Australian family physician.

[13]  Jonathan L. Shapiro,et al.  Smartphone Use and Acceptability Among Clinical Medical Students: A Questionnaire-Based Study , 2013, Journal of Medical Systems.

[14]  Daniel B. Jones,et al.  Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient—2013 update: Cosponsored by american association of clinical endocrinologists, The obesity society, and american society for metabolic & bariatric surgery* , 2013, Obesity.

[15]  R. Brady,et al.  Smartphone Applications (Apps) for Bariatric Surgery , 2013, Obesity Surgery.

[16]  R. Endevelt,et al.  The role of dietician follow-up in the success of bariatric surgery. , 2013, Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery.

[17]  Robert L. Robinson,et al.  Tablet Computer Use by Medical Students in the United States , 2012, Journal of Medical Systems.

[18]  M. Allman-Farinelli,et al.  Feasibility and validity of mobile phones to assess dietary intake. , 2014, Nutrition.

[19]  Jessica R L Lieffers,et al.  Use of mobile device applications in Canadian dietetic practice. , 2014, Canadian journal of dietetic practice and research : a publication of Dietitians of Canada = Revue canadienne de la pratique et de la recherche en dietetique : une publication des Dietetistes du Canada.

[20]  K. C. Koh,et al.  MEDICAL STUDENTS' PERCEPTIONS REGARDING THE IMPACT OF MOBILE MEDICAL APPLICATIONS ON THEIR CLINICAL PRACTICE , 2014 .

[21]  C. Bisogni,et al.  Gastric bypass patients’ goal-strategy-monitoring networks for long-term dietary management , 2014, Appetite.

[22]  R. Brady,et al.  Smartphone and medical applications use by contemporary surgical trainees: A national questionnaire study , 2014 .

[23]  Deborah Lupton,et al.  Apps as Artefacts: Towards a Critical Perspective on Mobile Health and Medical Apps , 2014 .

[24]  D. Fenton-Lee,et al.  Does Patient Compliance with Follow-up Influence Weight Loss After Gastric Bypass Surgery? A Systematic Review and Meta-Analysis , 2014, Obesity Surgery.

[25]  Amy M. Bauer,et al.  Use of Mobile Health (mHealth) Tools by Primary Care Patients in the WWAMI Region Practice and Research Network (WPRN) , 2014, The Journal of the American Board of Family Medicine.

[26]  Byron Havard,et al.  Mental Health Mobile Apps: From Infusion to Diffusion in the Mental Health Social System , 2015, JMIR mental health.

[27]  T. Perry,et al.  Diet App Use by Sports Dietitians: A Survey in Five Countries , 2015, JMIR mHealth and uHealth.

[28]  C. K. Nikolaou,et al.  Mobile applications for obesity and weight management: current market characteristics , 2017, International Journal of Obesity.

[29]  A. Bauman,et al.  The use of smartphone health apps and other mobile health (mHealth) technologies in dietetic practice: a three country study , 2017, Journal of human nutrition and dietetics : the official journal of the British Dietetic Association.