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Patient ‘investment’

RCT to assess the role of patient ‘investment’

Does the ‘greater the sense of investment’ result in successful weight loss?

Researchers in the UK have announced the creation of a randomised clinical trial that will examine if successful weight loss post-surgery can be attributed in part to the amount of investment the patient feels that they have made in their operation. There is evidence to suggest that patients who feel that surgery has taken more time and effort to organise, has cost more money, has been more disruptive to their lives and has caused pain are more likely to lose weight after their operation. The trial will assess whether the ‘greater the sense of investment’ does result in successful weight loss between two groups: a control and an investment intervention group.

The study will ask half the patients to rate and describe the investment they have made in their operation just before surgery then three and six months after surgery. All patients will record their weight, beliefs about food, intentions to change and actual eating and exercise behaviour at baseline then three, six and 12 months follow up.

The patients will be recruited from the bariatric surgery pre-assessment clinic at University College Hospital, London, UK. The primary outcome is to explore the impact of the investment based intervention on patient’s weight and BMI, with secondary outcomes of patients’ beliefs about foods, behavioural intentions and diet and exercise behaviours.

In particular, the questions will encourage patients to consider the ways in which the surgery has impacted upon them in terms of financial, social, personal and physical costs and focuses on factors such as pain, disruption to their family, social and work lives and financial burden. The investment intervention will be tailored to the recent experiences of the participants. To this end the questions and responses are framed in such a way as to emphasise investment in the process of bariatric surgery in order to optimise the outcomes of the procedure.

The researchers hope to collect data from at least 120 participants at 12 months follow up (60 in each group), which should provide statistical power to detect a small to medium difference in weight (controlling for baseline weight) by 12 months follow up.

“It is predicted that the investment intervention will improve excess weight loss post-surgery, together with beliefs about food, intentions to change and actual change in diet and exercise behaviour,” the researcher note. “This has cost implications for the NHS and other healthcare providers as improved effectiveness of bariatric surgery reduces the health costs of obese patients in the longer term and this simple, easy to administer and low cost intervention could become routine practice for bariatric patients.”

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