Factors Affecting Patient Adherence to Multivitamin Intake After Bariatric Surgery: Thematic Analysis of Qualitative Data From a Multicenter Study

Smelt, H.J.M.; Pouwels, S.; Heusschen, L.; Hazebroek, E.J.; van Rutte, P.W.J.; Theel, W.; Smulders, J.F.


Adherence to daily intake of multivitamin supplementation (MVS) is a major challenge after bariatric surgery (BS). The aim of this study was to identify insights into patients’ beliefs and experiences on adherence to MVS intake.
A thematic analysis of qualitative data from four high-volume bariatric centers in the Netherlands was conducted. A series of texts from the open-ended question of 1,246 patients were thematically analyzed for common or overarching themes, ideas, and patterns.
Five key themes emerged regarding participants’ suggestions on adherence to daily MVS intake: “gastrointestinal side effects to MVS intake” (n = 850, 68.2%), “negative features of MVS” (n = 296, 23.8%), “satisfaction with advice on MVS” (n = 272, 21.8%), “dissatisfaction with service provision” (n = 160, 12.8%), and “costs” (n = 93, 7.5%). Most problems were experienced when using specialized weight loss surgery (WLS) MVS. These supplements may cause gastrointestinal side effects, and costs are too high. After bariatric surgery, numerous patients strongly felt that information provision was poor in several aspects, and the aftercare pathway process did not provide sufficient support.
This study found five major themes involved in patient adherence to multivitamin intake after BS: gastrointestinal side effects to MVS intake, negative features of MVS, satisfaction with advice on MVS, dissatisfaction with service provision, and costs of specialized MVS. Challenges lie in stronger education for both patients and healthcare professionals. More personalized care could probably increase patient satisfaction, and MVS companies should look at further optimizing supplements for better tolerability and reducing costs.