Turkish primary care physicians’ attitudes and knowledge
of obesity and bariatric surgery: a survey study

Özgüç, Halil; Narmanlı, Mustafa; ÇIRNAZ, Hakan

Turkish primary care physicians’ attitudes and knowledge of obesity and bariatric surgery: a survey study

Halil Özgüç, (Genel Cerrahi Kliniği, Özel Medicabil Hastanesi, Bursa, Türkiye)

Mustafa Narmanlı, (Genel Cerrahi Kliniği, Özel Medicabil Hastanesi, Bursa, Türkiye)

Hakan Çırnaz (Genel Cerrahi Kliniği, Özel Medicabil Hastanesi, Bursa, Türkiye)

Turkish Journal of Surgery

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Yıl: 2021 Cilt: 37 Sayı: 3 Sayfa Aralığı: 266 - 276 Metin Dili: İngilizce İndeks Tarihi: 01-06-2022

Turkish primary care physicians’ attitudes and knowledge of obesity and bariatric surgery: a survey study

Öz:

Objective: This survey study attempted to determine Turkish primary care physicians’(PCP) knowledge, attitudes, and perceptions of obesity treatment and bariatric surgery. Moreover, the relationship between the duration of practice as a physician, and especially the indications for bariatric surgery and referral to surgery were investigated. Material and Methods: A survey of 27 questions was administered via social media and the internet using the SurveyMonkey platform. The physicians who responded to the survey were grouped based on the duration of working life. Among these groups, the responses to the questions about bariatric surgery were compared using univariate analysis. Results: A total of 1044 physicians responded to the survey. The number of physicians who strongly agreed that a PCP should play role in the treatment of obesity was 743 (71.1%). The most important reason for not undertaking this treatment was reported as the requirement for a multidisciplinary ap- proach to obesity treatment (51.5%, n= 537). The percentage of those who thought that patients with a body mass index (BMI) above 40 kg/m2 should be referred to surgery was 72.3%,while the percentage of those referring patients with a BMI of 35-40 kg/m 2 and comorbidities to surgery was 53.3%, and the percentage of those referring patients with a BMI of 35-40 kg/m 2 and uncontrolled diabetes to surgery was 35.9%. Physicians who were new to the profession were found to evaluate surgical indications more positively (p< 0.05). Conclusion: This study found that PCPs in Turkey had a basic knowledge of obesity treatment and were willing to treat and follow up these patients. However, it was observed that they could not adequately focus on this issue due to the requirement for a multidisciplinary approach to the disease and the workload. It was found that the young physicians› level of knowledge of bariatric surgery was higher, but their attitudes towards patient referral were similar

Anahtar Kelime:

Türkiye birinci basmak hekimlerinin obezite ve bariatrik cerrahi hakkında bilgi ve tutumları: Anket çalışması

Öz:

Giriş ve Amaç: Bu anket çalışması Türkiye birinci basamak hekimlerinin (BBH) obezite ve bariatrik cerrahi hakkındaki bilgi, tutum ve algılarını ölçmek amacıyla yapılmıştır. Ayrıca hekimlerin çalışma süreleri ve özellikle bariatrik cerrahi ve cerrahiye hasta yönlendirmeleri arasındaki ilişki araştırılmıştır. Gereç ve Yöntem: Yirmi yedi soruluk bir anket Survey monkey üzerinde yürürlüğe konarak sosyal medya ve internet aracılığıyla hekimlere ulaş- tırıldı. Hekimler çalışma sürelerine göre gruplandırıldı. Bu gruplar bariatrik cerrahiye verdikleri cevap açısından univaryans analiz kullanılarak karşılaştırıldı. Bulgular: Toplam 1044 hekim ankete katıldı. Obezite tedavisinde BBH’lerinin önemli bir rol oynayabileceğine kesinilkle katılan/katılan hekim sayısı 743 (%71,1) olmuştur. Bu hastaların tedavilerini üstlenmemelerinin en önemli nedeni olarak tedavinin multidispliner olması belirtilmiştir (%51,5, n= 537). Beden kitle indeksi (BMİ) 40 kg/m 2 üzeri olan hastaları cerrahiye yönlendireceğini söyleyen hekim oranı %72,3, BMİ 35-40 kg/m 2 olan ve beraberinde yandaş hastalığı olan hastaları cerrahiye yönlendirme oranı %53,3 ve BMİ 30-35 kg/m 2 ve kontrolsüz diyabeti olan hastaları yönlendirme oranı %35,9. Çalışma süresi daha yeni olan hekimlerin cerrahi endikasyonları daha olumlu değerlendikleri bulunmuştur (p< 005). Sonuç: Bu çalışmada Türkiye BBH’lerinin obezite tedavisi konusunda temel bilgi düzeyine sahip oldukları ve tedaviye katılma konusunda istekli oldukları görülmüştür. Bununla beraber multidisipliner yaklaşım gerekmesi ve iş yükü nedeniyle bu hastalarla ilgilenemediklerini belirtmişlerdir. Çalışma süresi açısından daha yeni olan hekimlerin hastaları cerrahiye yönlendirme açısından daha yüksek bilgi oranına sahip oldukları ancak hastaları sevketme oranının benzer olduğu görülmüştür.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. The Republic of Turkey Health Ministry.General Directorate of Public Health. Activity report (2019). Available from: https://dosyasb.saglik. gov.tr [CrossRef]
2. Chooi YC, Ding C, Magkos F. The epidemiology of obesity. Metabolism 2019; 92: 6-10 [CrossRef]
3. Bray GA, Fruhbeck G, Ryan DH, Wilding JP. Management of obesity. Lancet 2016; 387(10031): 1947-56. [CrossRef]
4. Ma J, Jr Urizar GG, Alehegn T, Stafford RS. Diet and physical activity co- unseling during ambulatory care visits in the United States. Prev Med 2004; 39(4): 815-22. [CrossRef]
5. Logue E, Sutton K, Jarloura D, Smucker W. Obesity management in primary care: assessment of readiness to change among 284 family practice patients.J Am Board Fam Pract 2000; 13(3): 164-71. [CrossRef]
6. Cardoso L, Rodrigues D, Carrilho F. Short and long-term mortality af- ter bariatric surgery: A systematic review and meta-analysis. Diabetes Obes Metab 2017; 19(9): 1223-32. [CrossRef]
7. Kallies KJ, Borgert AJ, Kothari SN. Patient perceptions of primary care providers’ knowledge of bariatric surgery. Clin Obes 2019; 9(2): e12297. [CrossRef]
8. Hirpara DH, Cleghom MC, Kwong J, Saleh F, Sockalingam S, Quereshy FA, et al. Perception and awareness of bariatric surgery in Canada: A national survey of general surgeons. Obes Surg 2016; 26(8): 1799-805. [CrossRef]
9. Bocquier A, Verger P, Basdevant A, Andreotti G, Baretge J, Villani P, et al. Overweight and obesity: Knowledge, attitudes, and practices of gene- ral practitioners in France. Obes Res 2005; 13(4): 787-95. [CrossRef]
10. Piccinini-Vallis H. Diagnosis management of obesity: a survey of ge - neral practitioners’ awareness of familiarity with the 2006 Canadian clinical practice guidelines.Can J Diabetes 2011; 35: 269-73. [CrossRef]
11. Tsai AG, Remmert JE, Butryn ML, Wadden TA. Treatment of obesity in primary care. Med Clin North Am 2018; 102(1): 35-47. [CrossRef]
12. The Look AHEAD Research Group. Eight-year weight losses with an intensive lifestyle intervention: The look AHEAD study. Obesity (Siver Spring) 2014; 22(1): 5-13 [CrossRef]
13. Schauer PR, Bhatt DL, Kirwan JP, Wolski K, Ali Aminian A, Brethaue SA, et al. Bariatric surgery versus intensive medical therapy for diabetes:5- year outcomes. N Eng J Med 2017; 376(7): 641-51. [CrossRef]
14. Fogelman Y, Vinker S, Lachter J, Biderman A, Ithzak B, Kitai E. Ma- naging obesity: a survey of attitudes and practices among Israeli primary care physicians.Int J Obes Relat Metab Disord 2002; 26(10): 1393-7. [CrossRef]
15. Glauser TA, Roepke N, Stevenin B, Dubois AM, Ahn SM. Physician knowledge about and perceptions of obesity management. Obes ReS Clin Pract 2015; 9(6): 573-83. [CrossRef]
16. Falvo AM, Philp FH, Eid GM. Primary care provider management of patients with obesity at an integrated health network: a survey of practices, views, and knowledge. Surg Obes relat Diseas 2018; 14(8): 1149-54. [CrossRef]
17. Conaty EA, Denham W, Haggerty SP, Linn JG, Joehl RJ, Ujiki MB. Pri- mary care physicians’ perceptions of bariatric surgery and major bar- riers to refrral. Obes Surg 2020; 30(2): 521-6. [CrossRef]
18. Stolberg CR, Hepp N, Juhl AJA, B CD, Juhl CB. Primary care physician decision making regarding referral for bariatric surgery: a national survey. Surg Obes Relat Dis 2017; 13(5): 807-13. [CrossRef]
19. Auspitz M, Cleghorn MC, Azin A, Sockalingam S, Quereshy FA, Okra- inec A, et al: Knowledge and perception of bariatric surgery among primary care phsicians:a survey of family doctors in Ontario. Obes Surg 2016; 26(9): 2022-8. [CrossRef]
20. El-Beheiry M, Vergis A, Choi JU, Clouston K, Hardy K. A survey of primary care physician referral to bariatric surgery in Manitoba: Access, percepti- ons and barriers. Ann Transl Med 2020; 8(Suppl 1): S3. [CrossRef]
21. Di Lorenzo N, Antoniou SA, Batterham RL, Busetto L, Godoroja D, Iossa A, et al: Clinical practice guidelines of the European Association for Endos- copic Surgery(EAES) on bariatric surgery: update 2020 endorsed by IFSO- EC, EASO and ESPCOP. Surg Endosc 2020; 34(6): 2332-58. [CrossRef]
22. Sarwer DB, Ritter S, Wadden TA, Spitzer JC, Vetter ML, Moore RH. Physi- cians’ attitudes about referring their type 2 diabetes patients for bari- atric surgery. Surg Obes Relat Dis 2012; 8(4): 381-6. [CrossRef]
23. McGlone ER, Wingfield LR, Munasinghe A, Batterham RL, Reddy M, Khan OA. A pilot study of primary care physicians’ attitude to weight loss surgery in England: are the young more prejudiced. Surg Obes Re- lat Diseas 2018; 14(3): 376-80. [CrossRef]
24. Stanford FC, Johnson ED, Claridy MD, Earle RL, Kaplan LM. The role of obesity training in medical school and residency on bariatric surgery knowledge in primary care physicians.Int J Family Med 2015; 2015: 841249. [CrossRef]

APA	Özgüç H, Narmanlı M, ÇIRNAZ H (2021). Turkish primary care physicians’ attitudes and knowledge of obesity and bariatric surgery: a survey study. , 266 - 276.
Chicago	Özgüç Halil,Narmanlı Mustafa,ÇIRNAZ Hakan Turkish primary care physicians’ attitudes and knowledge of obesity and bariatric surgery: a survey study. (2021): 266 - 276.
MLA	Özgüç Halil,Narmanlı Mustafa,ÇIRNAZ Hakan Turkish primary care physicians’ attitudes and knowledge of obesity and bariatric surgery: a survey study. , 2021, ss.266 - 276.
AMA	Özgüç H,Narmanlı M,ÇIRNAZ H Turkish primary care physicians’ attitudes and knowledge of obesity and bariatric surgery: a survey study. . 2021; 266 - 276.
Vancouver	Özgüç H,Narmanlı M,ÇIRNAZ H Turkish primary care physicians’ attitudes and knowledge of obesity and bariatric surgery: a survey study. . 2021; 266 - 276.
IEEE	Özgüç H,Narmanlı M,ÇIRNAZ H "Turkish primary care physicians’ attitudes and knowledge of obesity and bariatric surgery: a survey study." , ss.266 - 276, 2021.
ISNAD	Özgüç, Halil vd. "Turkish primary care physicians’ attitudes and knowledge of obesity and bariatric surgery: a survey study". (2021), 266-276.

APA	Özgüç H, Narmanlı M, ÇIRNAZ H (2021). Turkish primary care physicians’ attitudes and knowledge of obesity and bariatric surgery: a survey study. Turkish Journal of Surgery, 37(3), 266 - 276.
Chicago	Özgüç Halil,Narmanlı Mustafa,ÇIRNAZ Hakan Turkish primary care physicians’ attitudes and knowledge of obesity and bariatric surgery: a survey study. Turkish Journal of Surgery 37, no.3 (2021): 266 - 276.
MLA	Özgüç Halil,Narmanlı Mustafa,ÇIRNAZ Hakan Turkish primary care physicians’ attitudes and knowledge of obesity and bariatric surgery: a survey study. Turkish Journal of Surgery, vol.37, no.3, 2021, ss.266 - 276.
AMA	Özgüç H,Narmanlı M,ÇIRNAZ H Turkish primary care physicians’ attitudes and knowledge of obesity and bariatric surgery: a survey study. Turkish Journal of Surgery. 2021; 37(3): 266 - 276.
Vancouver	Özgüç H,Narmanlı M,ÇIRNAZ H Turkish primary care physicians’ attitudes and knowledge of obesity and bariatric surgery: a survey study. Turkish Journal of Surgery. 2021; 37(3): 266 - 276.
IEEE	Özgüç H,Narmanlı M,ÇIRNAZ H "Turkish primary care physicians’ attitudes and knowledge of obesity and bariatric surgery: a survey study." Turkish Journal of Surgery, 37, ss.266 - 276, 2021.
ISNAD	Özgüç, Halil vd. "Turkish primary care physicians’ attitudes and knowledge of obesity and bariatric surgery: a survey study". Turkish Journal of Surgery 37/3 (2021), 266-276.