Background

Duodenal Switch (DS) patients are a group of patients in a high-risk category for severe, preventable nutritional deficiencies. As such, they require close follow-up and yearly lab monitoring. Due to a variety of factors, this routine follow-up may not occur. The aim of this study was to evaluate shortfalls in DS patient follow-up, intervene by contacting all 'off track' DS patients, and ultimately, schedule them a clinic appointment for nutrition monitoring and risk assessment.

Methods

Patients who had DS surgery from January 2017 until March 2022 were retrospectively reviewed. The date of their procedure, type of procedure (robotic vs. laparoscopic) and subsequent follow-up intervals (1 week post op, 31-day Diet Advancement, 3-month, 6-month, 9-month, 1-year, 1.5-year, 2 years, and annual visits thereafter) were evaluated.

Results

60 DS patients were included in this study. 24 of the DS patients were considered 'off track' and received intervention. There was an 8.3% (n=24) response rate after our first (letter) intervention, and there was a 65% (n=17) response rate after our monthly phone calls (spanning 3 months). The combination of both interventions showed a 77% response rate and a significant improvement in DS patient follow-up.

Conclusions

Our two outreach interventions decreased our 'off track' patients from 45% to 24%. Patients are more likely to make an appointment with telephone call outreach (65%) compared to letter outreach (8.3%). Electronic medical records can be utilized to monitor follow-up and help increase compliance.