PMID- 38293039 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240320 DP - 2024 Jan 21 TI - Enhanced Patient Portal Engagement Associated with Improved Weight Loss Outcomes in Post-Bariatric Surgery Patients. LID - 2024.01.20.24301550 [pii] LID - 10.1101/2024.01.20.24301550 [doi] AB - BACKGROUND: Bariatric surgery is an effective intervention for obesity, but it requires comprehensive postoperative self-management to achieve optimal outcomes. While patient portals are generally seen as beneficial in engaging patients in health management, the link between their use and post-bariatric surgery weight loss remains unclear. OBJECTIVE: This study investigated the association between patient portal engagement and postoperative body mass index (BMI) reduction among bariatric surgery patients. METHODS: This retrospective longitudinal study included patients who underwent Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) at Vanderbilt University Medical Center (VUMC) between January 2018 and March 2021. Using generalized estimating equations, we estimated the association between active days of postoperative patient portal use and the reduction of BMI percentage (%BMI) at 3, 6, and 12 months post-surgery. Covariates included duration since surgery, the patient's age at the time of surgery, gender, race and ethnicity, type of bariatric surgery, severity of comorbid conditions, and socioeconomic disadvantage. RESULTS: The study included 1,415 patients, mostly female (80.9%), with diverse racial and ethnic backgrounds. 805 (56.9%) patients underwent RYGB and 610 (43.1%) underwent SG. By one-year post-surgery, the mean (SD) %BMI reduction was 31.1% (8.3%), and the mean (SD) number of patient portal active days was 61.0 (41.2). A significantly positive association was observed between patient portal engagement and %BMI reduction, with variations revealed over time. Each 10-day increment of active portal use was associated with a 0.57% ([95% CI: 0.42- 0.72], P < .001) and 0.35% ([95% CI: 0.22- 0.49], P < .001) %BMI reduction at 3 and 6 months postoperatively. The association was not statistically significant at 12 months postoperatively (beta=-0.07, [95% CI: -0.24- 0.09], P = .54). Various portal functions, including messaging, visits, my record, medical tools, billing, resources, and others, were positively associated with %BMI reduction at 3- and 6-months follow-ups. CONCLUSIONS: Greater patient portal engagement, which may represent stronger adherence to postoperative instructions, better self-management of health, and enhanced communication with care teams, was associated with improved postoperative weight loss. Future investigations are needed to identify important portal features that contribute to the long-term success of weight loss management. FAU - Zhang, Xinmeng AU - Zhang X AUID- ORCID: 0000-0001-7876-0753 AD - Department of Computer Science, Vanderbilt University, Nashville, TN. FAU - Kang, Kaidi AU - Kang K AUID- ORCID: 0000-0003-0922-5727 AD - Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN. FAU - Yan, Chao AU - Yan C AUID- ORCID: 0000-0002-6719-1388 AD - Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN. FAU - Feng, Yubo AU - Feng Y AUID- ORCID: 0000-0002-5446-9125 AD - Department of Computer Science, Vanderbilt University, Nashville, TN. FAU - Vandekar, Simon AU - Vandekar S AUID- ORCID: 0000-0002-7457-9073 AD - Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN. FAU - Yu, Danxia AU - Yu D AUID- ORCID: 0000-0002-1710-9382 AD - Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA. FAU - Rosenbloom, S Trent AU - Rosenbloom ST AUID- ORCID: 0000-0001-7455-2260 AD - Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN. AD - Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA. FAU - Samuels, Jason AU - Samuels J AD - Department of Surgery, Vanderbilt University School of Medicine, Nashville, TN, USA. FAU - Srivastava, Gitanjali AU - Srivastava G AUID- ORCID: 0000-0002-8326-3089 AD - Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA. AD - Department of Surgery, Vanderbilt University School of Medicine, Nashville, TN, USA. AD - Division of Diabetes, Endocrinology & Metabolism, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA. AD - Vanderbilt Weight Loss Center, Vanderbilt University Medical Center, Nashville, TN, USA. FAU - Williams, Brandon AU - Williams B AD - Department of Surgery, Vanderbilt University School of Medicine, Nashville, TN, USA. AD - Vanderbilt Weight Loss Center, Vanderbilt University Medical Center, Nashville, TN, USA. FAU - Albaugh, Vance L AU - Albaugh VL AUID- ORCID: 0000-0002-5267-8951 AD - Metamor Institute, Pennington Biomedical Research Center, Baton Rouge, LA, USA. FAU - English, Wayne J AU - English WJ AUID- ORCID: 0000-0001-9663-5761 AD - Department of Surgery, Vanderbilt University School of Medicine, Nashville, TN, USA. AD - Vanderbilt Weight Loss Center, Vanderbilt University Medical Center, Nashville, TN, USA. FAU - Flynn, Charles R AU - Flynn CR AD - Department of Surgery, Vanderbilt University School of Medicine, Nashville, TN, USA. AD - Vanderbilt Weight Loss Center, Vanderbilt University Medical Center, Nashville, TN, USA. FAU - Chen, You AU - Chen Y AUID- ORCID: 0000-0001-8232-8840 AD - Department of Computer Science, Vanderbilt University, Nashville, TN. AD - Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN. LA - eng GR - P30 DK058404/DK/NIDDK NIH HHS/United States GR - R01 DK126721/DK/NIDDK NIH HHS/United States PT - Preprint DEP - 20240121 PL - United States TA - medRxiv JT - medRxiv : the preprint server for health sciences JID - 101767986 PMC - PMC10827275 OTO - NOTNLM OT - bariatric surgery OT - patient engagement OT - patient portal COIS- GS receives consulting fees from Novo Nordisk, Rhythm Pharmaceuticals, and Eli Lilly. GS is on the Speaker's Bureau for Novo Nordisk and Rhythm Pharmaceutical and receives industry support for clinical trials from Eli Lilly. EDAT- 2024/01/31 06:42 MHDA- 2024/01/31 06:43 PMCR- 2024/01/30 CRDT- 2024/01/31 04:19 PHST- 2024/01/31 06:42 [pubmed] PHST- 2024/01/31 06:43 [medline] PHST- 2024/01/31 04:19 [entrez] PHST- 2024/01/30 00:00 [pmc-release] AID - 2024.01.20.24301550 [pii] AID - 10.1101/2024.01.20.24301550 [doi] PST - epublish SO - medRxiv [Preprint]. 2024 Jan 21:2024.01.20.24301550. doi: 10.1101/2024.01.20.24301550.