Measuring Knowledge, Attitudes, and Barriers to Medication Adherence in Potential Bariatric Surgery Patients.
Alexithymia
Bariatric surgery
Binge eating
Medication adherence
Obesity
Psychopathology
Journal
Obesity surgery
ISSN: 1708-0428
Titre abrégé: Obes Surg
Pays: United States
ID NLM: 9106714
Informations de publication
Date de publication:
09 2021
09 2021
Historique:
received:
22
12
2020
accepted:
14
05
2021
revised:
09
05
2021
pubmed:
3
7
2021
medline:
28
9
2021
entrez:
2
7
2021
Statut:
ppublish
Résumé
Bariatric surgery is an effective treatment for the obesity epidemic, but the poor attendance and adherence rates of post-surgery recommendations threaten treatment effectiveness and health outcomes. Preoperatively, we investigated the unique contributions of clinical (e.g., medical and psychiatric comorbidities), sociodemographic (e.g., sex, age, and educational level), and psychopathological variables (e.g., binge eating severity, the general level of psychopathological distress, and alexithymia traits) on differing dimensions of adherence in a group of patients seeking bariatric surgery. The final sample consisted of 501 patients (346 women). All participants underwent a full psychiatric interview. Self-report questionnaires were used to assess psychopathology, binge eating severity, alexithymia, and three aspects of adherence: knowledge, attitude, and barriers to medical recommendations. Attitude to adherence was associated with alexithymia (β = -2.228; p < 0.001) and binge eating disorder (β = 0.103; p = 0.047). The knowledge subscale was related to medical comorbidity (β = 0.113; p = 0.012) and alexithymia (β = -2.256; p < 0.001); with age (β = 0.161; p = 0.002) and psychiatric comorbidity (β =0.107; p = 0.021) manifesting in the barrier subscale. We demonstrated that alexithymia and psychiatric and eating disorders impaired adherence reducing attitude and knowledge of treatment and increasing the barriers. Both patient and doctor can benefit from measuring adherence prior to surgery, with a qualitative approach shedding light on the status of adherence prior to the postsurgical phase when the damage regarding adherence is, already, done. Graphical Abstract.
Sections du résumé
BACKGROUND
Bariatric surgery is an effective treatment for the obesity epidemic, but the poor attendance and adherence rates of post-surgery recommendations threaten treatment effectiveness and health outcomes. Preoperatively, we investigated the unique contributions of clinical (e.g., medical and psychiatric comorbidities), sociodemographic (e.g., sex, age, and educational level), and psychopathological variables (e.g., binge eating severity, the general level of psychopathological distress, and alexithymia traits) on differing dimensions of adherence in a group of patients seeking bariatric surgery.
METHODS
The final sample consisted of 501 patients (346 women). All participants underwent a full psychiatric interview. Self-report questionnaires were used to assess psychopathology, binge eating severity, alexithymia, and three aspects of adherence: knowledge, attitude, and barriers to medical recommendations.
RESULTS
Attitude to adherence was associated with alexithymia (β = -2.228; p < 0.001) and binge eating disorder (β = 0.103; p = 0.047). The knowledge subscale was related to medical comorbidity (β = 0.113; p = 0.012) and alexithymia (β = -2.256; p < 0.001); with age (β = 0.161; p = 0.002) and psychiatric comorbidity (β =0.107; p = 0.021) manifesting in the barrier subscale.
CONCLUSION
We demonstrated that alexithymia and psychiatric and eating disorders impaired adherence reducing attitude and knowledge of treatment and increasing the barriers. Both patient and doctor can benefit from measuring adherence prior to surgery, with a qualitative approach shedding light on the status of adherence prior to the postsurgical phase when the damage regarding adherence is, already, done. Graphical Abstract.
Identifiants
pubmed: 34212345
doi: 10.1007/s11695-021-05485-9
pii: 10.1007/s11695-021-05485-9
pmc: PMC8397664
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
4045-4054Informations de copyright
© 2021. The Author(s).
Références
Patient Educ Couns. 2010 Mar;78(3):372-6
pubmed: 19773144
Updates Surg. 2017 Mar;69(1):101-107
pubmed: 28266000
Control Clin Trials. 2000 Oct;21(5 Suppl):188S-94S
pubmed: 11018574
Eat Weight Disord. 2021 Jun;26(5):1685-1690
pubmed: 32654003
Obes Surg. 2014 Sep;24(9):1469-75
pubmed: 24570091
Obes Surg. 2004 Nov-Dec;14(10):1402-5
pubmed: 15603659
J Behav Med. 2016 Dec;39(6):1092-1103
pubmed: 27444752
Nutrients. 2020 Mar 01;12(3):
pubmed: 32121618
Obes Surg. 2018 Apr;28(4):1130-1135
pubmed: 29076007
J Pers Assess. 2007 Dec;89(3):230-46
pubmed: 18001224
Behav Res Methods. 2009 Nov;41(4):1149-60
pubmed: 19897823
Surg Obes Relat Dis. 2018 Aug;14(8):1192-1201
pubmed: 29853195
Lancet Psychiatry. 2019 Aug;6(8):675-712
pubmed: 31324560
Eur J Intern Med. 2008 May;19(3):173-80
pubmed: 18395160
Riv Psichiatr. 2020 Jan-Feb;55(1):24-30
pubmed: 32051622
Psychosom Med. 2016 Apr;78(3):373-81
pubmed: 26569540
Riv Psichiatr. 2015 Nov-Dec;50(6):285-94
pubmed: 26780202
Eat Behav. 2007 Aug;8(3):296-304
pubmed: 17606227
Surg Obes Relat Dis. 2020 Feb;16(2):175-247
pubmed: 31917200
Riv Psichiatr. 2019 Jan-Feb;54(1):8-17
pubmed: 30760932
Heart Lung. 2008 Sep-Oct;37(5):334-43
pubmed: 18790334
J Obes. 2020 May 28;2020:9792518
pubmed: 32566276
Obesity (Silver Spring). 2009 May;17(5):996-1002
pubmed: 19165167
Eat Weight Disord. 2019 Feb;24(1):129-134
pubmed: 28353096
J Psychosom Res. 1994 Jan;38(1):23-32
pubmed: 8126686
Appetite. 2009 Feb;52(1):51-7
pubmed: 18778742
Ther Adv Psychopharmacol. 2015 Oct;5(5):278-88
pubmed: 26557984
JSLS. 2002 Oct-Dec;6(4):331-8
pubmed: 12500832
J Health Psychol. 2019 Mar;24(4):518-525
pubmed: 27852888
J Obes. 2017;2017:4703236
pubmed: 28261497
J Psychosom Res. 1996 Dec;41(6):551-9
pubmed: 9032718
Eat Weight Disord. 2021 Feb;26(1):103-114
pubmed: 31797330
Riv Psichiatr. 2019 May-Jun;54(3):127-130
pubmed: 31282493
Surg Obes Relat Dis. 2012 Sep-Oct;8(5):561-8
pubmed: 22551576
JAMA Surg. 2018 Jun 1;153(6):526-533
pubmed: 29450469
Hypertens Res. 2019 Feb;42(2):273-283
pubmed: 30518984
Res Nurs Health. 2005 Dec;28(6):488-95
pubmed: 16287052
Cochrane Database Syst Rev. 2016 Mar 14;3:CD006560
pubmed: 26976529
Psychol Med. 2016 Oct;46(14):2869-2881
pubmed: 27502153
Obes Surg. 2018 Oct;28(10):3054-3061
pubmed: 29774453
Obes Surg. 2019 Jul;29(7):2238-2246
pubmed: 30887307
N Engl J Med. 2010 Apr 29;362(17):1553-5
pubmed: 20375400
Front Psychol. 2020 May 19;11:836
pubmed: 32508706
Eur Eat Disord Rev. 2016 Mar;24(2):174-8
pubmed: 26147590
Front Endocrinol (Lausanne). 2021 May 05;12:662252
pubmed: 34025579
Obes Surg. 2020 Dec;30(12):4911-4918
pubmed: 32734571
Scand J Psychol. 2007 Oct;48(5):391-8
pubmed: 17877554
Surg Obes Relat Dis. 2012 Sep-Oct;8(5):533-41
pubmed: 22920965
Recenti Prog Med. 2016 Nov;107(11):564-566
pubmed: 27869872
Med Care Res Rev. 2018 Dec;75(6):746-761
pubmed: 29148336
Addict Behav. 1982;7(1):47-55
pubmed: 7080884
Obes Surg. 2005 Apr;15(4):552-60
pubmed: 15946437
Obes Surg. 2015 Apr;25(4):666-72
pubmed: 25204408
Obes Surg. 2013 Oct;23(10):1703-10
pubmed: 23934274
Obes Surg. 2016 Apr;26(4):810-5
pubmed: 26208411