title: Pre-Lap-Band group education in Medicaid population: does it really make a difference?
abstract: BACKGROUND
  The effect of group education classes before a Lap-Band procedure has not been well defined. We hypothesized that in a Medicaid population, the completion of a standardized 12-week multidisciplinary preoperative program (SMPP) would significantly improve the preoperative and early postoperative weight loss. All procedures were performed at a University-affiliated community hospital from 2006 to 2007.
  
  
  METHODS
  A prospectively collected database of 292 patients who underwent Lap-Band placement was retrospectively reviewed. All patients in the study cohort were encouraged to participate in the SMPP, which included medical, psychological, and nutritional interventions. The patients were divided into 2 groups according to their participation in the SMPP program: SMPP compliant and non-SMPP compliant. The postoperative weight loss of these 2 groups was then compared using the general linear models for repeated measures statistical analysis.
  
  
  RESULTS
  No significant difference was found in the mean baseline excess body weight between the 2 groups (74 +/- 20 kg in the SMPP-compliant and 76 +/- 20 kg in the non-SMPP-compliant participants). The mean baseline body mass index (47 +/- 7 versus 48 +/- 72 kg/m(2) for the SMPP-compliant and non-SMPP-compliant participants) was also similar in the 2 groups. The postoperative follow-up rate was 94.5% at 1 month, 72.3% at 6 months, and 52.7% at 12 months. The excess weight loss was significantly greater in the SMPP compliant group than in the noncompliant group during the observed 12-month follow-up period (P = .04, by general linear models for repeated measures).
  
  
  CONCLUSIONS
  In a Medicaid population, implementation of an intensive preoperative SMPP resulted in a significant improvement in the short-term weight loss after Lap-Band placement.
authors.affiliation: Bariatric and Metabolic Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA. talarij@ccf.org
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Talarico
authors.forename: Alfonso
authors.initials: A
authors.lastname: Torquati
authors.forename: Erin M
authors.initials: EM
authors.lastname: McCarthy
authors.forename: Steven
authors.initials: S
authors.lastname: Bonomo
authors.forename: Rami E
authors.initials: RE
authors.lastname: Lutfi
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000295:instrumentation*; D006785:Hospitals, University; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008484:Medicaid; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D010353:Patient Education as Topic / Q000379:methods*; D057234:Preoperative Period; D011379:Prognosis; D011446:Prospective Studies; D014481:United States; D015431:Weight Loss; D055815:Young Adult