title: Patient adherence in following a prescribed diet and micronutrient supplements after laparoscopic sleeve gastrectomy: our experience during 1 year of follow-up.
abstract: One of the most effective surgeries for sustainable weight loss in morbidly obese patients is laparoscopic sleeve gastrectomy (LSG). The present study aimed to assess the adherence of LSG patients with respect to following post-operative dietary requirements and micronutrient supplementation, as well as to investigate their perceived barriers in achieving optimal adherence.
  
  
  
  Retrospective data analysis was performed (3, 6, 9 and 12 months after LSG) using the medical records of 96 morbidly obese patients who had undergone LSG at our institution during 2011-2013. Data collected from patient records were: adherence to prescribed diet; adherence to prescribed consumption of fruit, vegetables, legumes and cereals; use of prescribed micronutrient supplements; and barriers to diet and micronutrient therapy adherence. Data were analysed using spss, version 14.0 (SPSS Inc., Chicago, IL, USA).
  
  
  
  At 3, 6, 9 and 12 months post-LSG, the rates of patient non-adherence to a prescribed diet were 39%, 45%, 51% and 74%, respectively. In particular, there was a low consumption of fruit, vegetables, legumes and cereals compared to the post-surgery prescription. In addition, the rates of patient non-adherence to prescribed micronutrient supplements at 3, 6, 9 and 12 months post-LSG were 43%, 51%, 59% and 67%, respectively. The main reasons for patient non-adherence to diet were poor self-discipline (72%) and poor family support (11%) whereas difficulty swallowing pills or capsules (61%) and cost (20%) were reported as the main barriers to post-LSG adherence.
  
  
  
  Morbidly obese patients who have undergone LSG do not follow exactly the post-operative dietary guidelines, including micronutrient therapy.
authors.affiliation: Department of Anaesthesiology, Surgery and Emergency Sciences, Integrated Assistential Department of General and Special Surgery (Cappella Cangiani), IX Division of General Surgery, Vascular and Applied Biotechnology, Second University of Naples, Naples, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Schiavo
authors.affiliation: Department of Anaesthesiology, Surgery and Emergency Sciences, Integrated Assistential Department of General and Special Surgery (Cappella Cangiani), IX Division of General Surgery, Vascular and Applied Biotechnology, Second University of Naples, Naples, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Scalera
authors.affiliation: Department of Medicine and Surgery, University of Salerno, Salerno, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Pilone
authors.affiliation: Department of Anaesthesiology, Surgery and Emergency Sciences, Integrated Assistential Department of General and Special Surgery (Cappella Cangiani), IX Division of General Surgery, Vascular and Applied Biotechnology, Second University of Naples, Naples, Italy.
authors.forename: G
authors.initials: G
authors.lastname: De Sena
authors.affiliation: Department of Anaesthesiology, Surgery and Emergency Sciences, Integrated Assistential Department of General and Special Surgery (Cappella Cangiani), IX Division of General Surgery, Vascular and Applied Biotechnology, Second University of Naples, Naples, Italy.
authors.forename: F R
authors.initials: FR
authors.lastname: Ciorra
authors.affiliation: Department of Anaesthesiology, Surgery and Emergency Sciences, Integrated Assistential Department of General and Special Surgery (Cappella Cangiani), IX Division of General Surgery, Vascular and Applied Biotechnology, Second University of Naples, Naples, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Barbarisi
mesh_terms: D000328:Adult; D015992:Body Mass Index; D004032:Diet; D019587:Dietary Supplements; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D010535:Laparoscopy; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage*; D008875:Middle Aged; D009751:Nutritional Requirements; D009767:Obesity, Morbid / Q000178:diet therapy / Q000601:surgery; D010349:Patient Compliance; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D018977:Micronutrients
keywords: barriers to recommended adherence; laparoscopic sleeve gastrectomy; post-operative dietary adherence; post-operative micronutrient supplement adherence