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Perceptions of weight, diabetes and willingness to participate in randomised controlled trials of bariatric surgery for patients with type 2 diabetes mellitus and body mass index 30-39.9 kg/m2

Perceptions of weight, diabetes and willingness to participate in randomised controlled trials of bariatric surgery for patients with type 2 diabetes mellitus and body mass index 30-39.9 kg/m2
Perceptions of weight, diabetes and willingness to participate in randomised controlled trials of bariatric surgery for patients with type 2 diabetes mellitus and body mass index 30-39.9 kg/m2
Purpose

Evidence from high-quality randomised controlled trials (RCTs) is needed to establish the long-term benefit of bariatric surgery in people with type 2 diabetes mellitus (T2DM) and body mass index (BMI) 30–39.9 kg/m2. However, willingness amongst this group to be randomised and undergo surgery is uncertain. This study assessed UK patients’ perceptions of their weight and diabetes, and associations with willingness to participate in RCTs involving bariatric surgery, amongst this population.

Materials and Methods

Postal survey of 1820 patients from four regions in England. Eligible patients were as follows: BMI 30–39.9 kg/m2, 18–74 years, diagnosis of T2DM ?2 years. A reminder survey was sent after 4 weeks. Independent predictors influencing patients’ willingness to consider RCT participation were identified using multiple logistic regression analysis.

Results

Thirty-four per cent (614/1820) of patients responded. Weight was considered to be harder to control than diabetes [468/584 (80 %) vs. 107/600 (17 %)]. More people reported a negative impact on life for weight rather than diabetes [379/579 (63 %) vs. 180/574 (31 %)]. Feeling unsatisfied/very unsatisfied with weight loss ability was common 261/578 (45 %). Sixty-four per cent (379/594, CI?=?60–68) were willing to consider participating in an RCT. In multivariate analysis, negative impact of weight on life (OR?=?2.55, 95 % CI?=?1.68–3.89, P?<?0.001) and feeling unsatisfied with weight loss ability (OR?=?2.47, 95 % CI?=?1.55–3.95, P?<?0.001) positively influenced patients’ willingness to participate in an RCT.

Conclusion

Strong patient interest supports the feasibility of such trials for this group. Perceptions of obesity negatively impacting on life and difficulties in achieving weight loss were common and influenced attitudes to potential participation in bariatric surgery RCTs.
type 2 diabetes, obesity treatment, patient preferences, bariatric surgery, survey research
0960-8923
1039-1046
Summers, Rachael H.
811d6b74-d5f4-4e92-a507-9bdca978fda5
Moore, M.
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Byrne, J.
d31b7acf-d522-476d-8837-06bfa5c95cd3
Byrne, C.
f22ab35b-8d98-41be-a89c-df9b1677dace
Mullee, M.
fd3f91c3-5e95-4f56-8d73-260824eeb362
Welbourn, R.
b9239e65-e325-41f9-9485-177ee23c5ec6
Elsey, H.
51776d3c-3a5e-4c34-8d71-73b678c0f22e
Roderick, P.
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Summers, Rachael H.
811d6b74-d5f4-4e92-a507-9bdca978fda5
Moore, M.
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Byrne, J.
d31b7acf-d522-476d-8837-06bfa5c95cd3
Byrne, C.
f22ab35b-8d98-41be-a89c-df9b1677dace
Mullee, M.
fd3f91c3-5e95-4f56-8d73-260824eeb362
Welbourn, R.
b9239e65-e325-41f9-9485-177ee23c5ec6
Elsey, H.
51776d3c-3a5e-4c34-8d71-73b678c0f22e
Roderick, P.
dbb3cd11-4c51-4844-982b-0eb30ad5085a

Summers, Rachael H., Moore, M., Byrne, J., Byrne, C., Mullee, M., Welbourn, R., Elsey, H. and Roderick, P. (2015) Perceptions of weight, diabetes and willingness to participate in randomised controlled trials of bariatric surgery for patients with type 2 diabetes mellitus and body mass index 30-39.9 kg/m2. Obesity Surgery, 25 (6), 1039-1046. (doi:10.1007/s11695-014-1479-4). (PMID:25416084)

Record type: Article

Abstract

Purpose

Evidence from high-quality randomised controlled trials (RCTs) is needed to establish the long-term benefit of bariatric surgery in people with type 2 diabetes mellitus (T2DM) and body mass index (BMI) 30–39.9 kg/m2. However, willingness amongst this group to be randomised and undergo surgery is uncertain. This study assessed UK patients’ perceptions of their weight and diabetes, and associations with willingness to participate in RCTs involving bariatric surgery, amongst this population.

Materials and Methods

Postal survey of 1820 patients from four regions in England. Eligible patients were as follows: BMI 30–39.9 kg/m2, 18–74 years, diagnosis of T2DM ?2 years. A reminder survey was sent after 4 weeks. Independent predictors influencing patients’ willingness to consider RCT participation were identified using multiple logistic regression analysis.

Results

Thirty-four per cent (614/1820) of patients responded. Weight was considered to be harder to control than diabetes [468/584 (80 %) vs. 107/600 (17 %)]. More people reported a negative impact on life for weight rather than diabetes [379/579 (63 %) vs. 180/574 (31 %)]. Feeling unsatisfied/very unsatisfied with weight loss ability was common 261/578 (45 %). Sixty-four per cent (379/594, CI?=?60–68) were willing to consider participating in an RCT. In multivariate analysis, negative impact of weight on life (OR?=?2.55, 95 % CI?=?1.68–3.89, P?<?0.001) and feeling unsatisfied with weight loss ability (OR?=?2.47, 95 % CI?=?1.55–3.95, P?<?0.001) positively influenced patients’ willingness to participate in an RCT.

Conclusion

Strong patient interest supports the feasibility of such trials for this group. Perceptions of obesity negatively impacting on life and difficulties in achieving weight loss were common and influenced attitudes to potential participation in bariatric surgery RCTs.

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More information

e-pub ahead of print date: 22 November 2014
Published date: June 2015
Keywords: type 2 diabetes, obesity treatment, patient preferences, bariatric surgery, survey research
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 372643
URI: http://eprints.soton.ac.uk/id/eprint/372643
ISSN: 0960-8923
PURE UUID: e6fc1ab4-43cc-4d96-86b4-98cd47429ca8
ORCID for Rachael H. Summers: ORCID iD orcid.org/0000-0001-9060-0584
ORCID for M. Moore: ORCID iD orcid.org/0000-0002-5127-4509
ORCID for P. Roderick: ORCID iD orcid.org/0000-0001-9475-6850

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Date deposited: 11 Dec 2014 17:01
Last modified: 15 Mar 2024 03:22

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Contributors

Author: Rachael H. Summers ORCID iD
Author: M. Moore ORCID iD
Author: J. Byrne
Author: C. Byrne
Author: M. Mullee
Author: R. Welbourn
Author: H. Elsey
Author: P. Roderick ORCID iD

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