Assessing Micronutrient Adherence after Bariatric Surgery: An Exploratory Study

Background: Micronutrient supplementation is a lifelong requirement following bariatric procedures in order to minimize longterm complications. However, little is known about patient adherence to postoperative micronutrient supplementation and the barriers for non-adherence. Objective: An exploratory study to examine self-reported adherence to micronutrient supplementation after bariatric surgery, investigate barriers to adherence, and identify factors affecting supplement purchase. Setting: Online survey posted in two community support forums for bariatric surgery patients. Methods: A survey was developed and aimed to collect bariatric surgery patient's demographic information, surgical history, baseline health; and assess adherence to micronutrient supplements, purchase, and barriers to adherence. Results: One hundred fifty four bariatric surgery recipients responded to the survey. The self-reported adherence rate for micronutrient supplementation ranged between 68.4% and 100%. Calcium and iron supplements had the lowest adherence rate. Forgetting to take the supplement and experiencing side effects were the two leading barriers to adherence (41.3% and 20.6% respectively). Other barriers included costs and palatability of the products. Ninetytwo percent of the study cohort purchased their supplements in local stores or through the internet. Having a bariatric branding on the product was the leading influencing factor in guiding purchases, followed by recommendations from care providers. Conclusions: Our study suggests that micronutrient nonadherence is a concern after bariatric surgery and may pose risks for long-term complications. These findings have provided the information to help design future investigations aimed to improve micronutrient supplement adherence, and maximize the long-term safety of bariatric surgery and other surgeries of the gastrointestinal tract.