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Primary care physicians' knowledge, attitudes and concerns about bariatric surgery and the association with referral patterns: a Swedish survey study
Lund University, Sweden.
Lund University, Sweden.
Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Lund University, Sweden;Region Skåne, Sweden.ORCID iD: 0000-0002-3785-5630
Lund University, Sweden.
2021 (English)In: BMC Endocrine Disorders, E-ISSN 1472-6823, Vol. 21, no 1, article id 62Article in journal (Refereed) Published
Sustainable development
SDG 3: Ensure healthy lives and promote well-being for all at all ages
Abstract [en]

Background Obesity prevalence is increasing globally. Bariatric surgery is an effective treatment for severe and complex obesity resulting in significant and sustained weight loss. In Sweden, most bariatric surgery patients are referred by primary care physicians. We aimed to explore barriers for physicians to refer patients with severe and complex obesity for bariatric surgery. Methods A questionnaire survey was in 2019 emailed to 1100 primary care physicians in the Skane and Kronoberg regions in south Sweden. The survey focused on referral patterns, knowledge and attitudes towards bariatric surgery and concerns about postoperative complications. We created different statistical indices for referral patterns, knowledge, attitudes and concerns about bariatric surgery. To analyze the correlation between these indices, we did Spearman's correlations and regression analyses. Results Of 1100 email respondents, we received 157 (14%) completed surveys. Among 157 physician respondents, 73% answered that they had good knowledge about the referral criteria for bariatric surgery, whereas 55 and 60% answered correctly to two items on criteria for bariatric surgery. A majority of respondents (84%) stated that their patients initiated referral to bariatric surgery. Half of the respondents had concerns about postoperative medical and surgical complications, but another half had a positive attitude to bariatric surgery as a treatment for obesity comorbidities. Almost half of the respondents (44%) answered that they needed to learn more about bariatric surgery. We found significant positive correlations between high knowledge and referral patterns (r = 0.292, p < 0.001) and positive attitudes (r = 0.235, p < 0.001) respectively. We found significant reverse correlations between concerns and referral patterns (r = - 0.355, p < 0.001) and between positive attitudes and concerns (r = - 0.294, p < 0.001). In logistic regression high levels of concerns explained low willingness to refer for bariatric surgery (Odds Ratio 0.2, 95% confidence interval 0.1-0.7). Conclusion According to this Swedish survey among primary care physicians, high levels of concerns about bariatric surgery among physicians seemed to be a barrier to refer patients with severe and complex obesity for bariatric surgery. Since high knowledge about obesity and bariatric surgery correlated negatively to concerns and positively to favorable attitudes to bariatric surgery, more knowledge about obesity and bariatric surgery is warranted.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2021. Vol. 21, no 1, article id 62
Keywords [en]
Obesity, Bariatric surgery, Survey study, Primary care physician, Knowledge, Referral, Attitudes
National Category
Other Medical Sciences
Research subject
Natural Science, Medicine
Identifiers
URN: urn:nbn:se:lnu:diva-103491DOI: 10.1186/s12902-021-00723-8ISI: 000638117300001PubMedID: 33832469Scopus ID: 2-s2.0-85104074379Local ID: 2021OAI: oai:DiVA.org:lnu-103491DiVA, id: diva2:1556282
Available from: 2021-05-21 Created: 2021-05-21 Last updated: 2023-09-13Bibliographically approved

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Thulesius, Hans

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CiteExportLink to record
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