Impact of telemedicine on improving access to metabolic/bariatric surgery care in minority and other underserved patients with obesity.

BACKGROUND

Individuals who come from vulnerable groups such as those from racial or ethnic minorities and/or those from low socioeconomic groups have a high prevalence of obesity but are less likely to receive metabolic/bariatric surgery (MBS). This is believed to be related to inequities in access to MBS due to travel (those living in rural communities), financial burden, and/or lack of education. The objective of this study is to understand the impact of telemedicine interventions on improving access to MBS in such groups.

SETTING

Academic Health Center.

METHODS

A search was conducted using EMBASE, Medline, and Google Scholar. Articles related to telemedicine in bariatric surgery patients published in peer-reviewed journals were reviewed and selected using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.

RESULTS

Of 131 articles reviewed, 8 met eligibility criteria, representing 6881 patients with a mean age of 47.9 years; majority of whom were female (>60%). Barriers to MBS access included distance, transportation, time off from work, and number of visits, leading to attrition rates exceeding 60% in some vulnerable populations. Telemedicine increased show rate over 2-fold and increased MBS throughput (odds ratio [OR] 3.53) in some vulnerable cohorts. Telemedicine use is also correlated with increased nutrition knowledge, better eating behavior, physical activity, and weight loss. Vulnerable groups, particularly from rural communities, had higher satisfaction ratings with telemedicine utilization.

CONCLUSION

The use of telemedicine interventions can have a significant impact on improving access and throughput to MBS among vulnerable groups, while achieving high satisfaction and low attrition rates.