Resource implications of a brief psychology triage tool for patients pre bariatric surgery: An audit of patient pathways

Purpose : Due to resource limitations, psychological support for bariatric patients needs to be targeted to those most in need. This study aimed to evaluate the resource implications of a brief triage tool to identify and support those most at risk from poorer outcomes Materials and methods : A four stage process was used involving: Expert consensus; the selection of appropriate measures; A patient cohort over two years; A resource analysis Results : Three key psychological contra-indications for bariatric surgery were identified by expert psychologists (n=45) as alcohol and drug dependency and suicidality. Next, existing validated measures were selected based upon the literature to form the Bariatric Triage Tool (BTT) consisting of the AUDIT, DAST-10 and SBQ-R. Consecutive patients at one UK bariatric clinic then completed the BTT for 2 years (n=484). Of these under a fifth were identified as at risk (n=85; 17.6%) and referred for an in depth one to one assessment with a bariatric psychologist. Of these 7 (1.4%) were referred to their GP for further psychological support and removed from the surgical pathway. Finally, resource implications were evaluated and indicated that the BTT saved both money (between £15 and £105 per patient depending on the metric) and time (just under one hour per patient) which could be used to target those patients most in need of psychological support Conclusion : The BTT is a brief, easy to self-administer tool that could be used to identify those most at risk and ensure that psychological support is targeted to those most in need