Adherence to Micronutrient Supplementation in Bariatric Patients

Abstract

Background Micronutrient deficiencies are key concerns after bariatric surgery. Routine supplementation of certain vitamins and minerals is a lifelong requirement following bariatric procedures to minimize the risks of nutritional deficiencies on health. However, little is known about bariatric patient adherence to postoperative supplementation. Objectives The aims of this study were to examine self-reported adherence to recommended micronutrient supplementation in bariatric patients, investigate their perceived barriers to achieving optimal adherence, and identify other factors that may affect patients' supplement purchase, choice and adherence. Methods An online survey was developed and posted to two community support forums for Roux-en-Y gastric bypass surgery and vertical sleeve gastrectomy on the website BariatricPal.com. Data were collected between June 2, 2014 and September 24, 2014, including demographic information; supplement use, purchase, choice and adherence; experienced barriers to adherence; and patients' views about their functional health. Results One hundred fifty four subjects who have undergone bariatric surgery responded to the survey. The micronutrients surveyed included multivitamin, thiamin, folic acid, iron, vitamin C, vitamin D, calcium, and vitamin B12. Self-reported adherence rate to routine micronutrient supplementation ranged from 75% for calcium to 100% for folic acid. Missing doses and side effects associated with taking supplements were identified as the two leading barriers to adherence (42.4% and 21.2%, respectively). Approximately 92% of the study cohort purchased their OTC supplements in local stores or through internet. Bariatric branded supplements was considered by 24% of the respondents as the most important factor influencing their choice of supplements, followed by recommendations from care provider which was reported by 23% of the study sample. Conclusions High self-reported adherence was observed in our study sample. However, the results showed that some respondents seemed not to be convinced by their care provider's instructions on postoperative nutritional care, and their barriers to supplement adherence were not adequately understood and addressed in follow-up care, which highlighted the need for providers to bridge the communication gap with bariatric patients and understand their perspectives and concerns regarding postoperative nutrient supplementation so as to optimize adherence to recommended micronutrient regimens.