Prof Dr Matthias Blüher and Prof Dr Michael Stumvoll are the leads of the Integrated Research and Treatment Center (IFB) for Adiposity Diseases, which is a COM for children, adolescents and adults based in the Leipzig University Medical Center in Germany. The specialist, multidisciplinary team working in this COM is made up of 12 physicians (endocrinologists, surgeons); 15 dieticians; and 6 psychologists.
It is great to learn about the activities of this COM. Please describe the education and training activities that your COM provides.
Our COM delivers curricular lectures about obesity and obesity treatment. These lectures are delivered across different degree courses and topics, spanning medicine, medicine for bioinformatics students, and internal medicine for dental students. At Leipzig University, there is also a compulsory elective subject course as an integral part of the medical course, called “Nutritional Medicine” which our COM is involved in. Staff in our COM also support and supervise PhD students in medicine and nutritional science working on their doctoral thesis, as well as students of nutritional science working on their master’s dissertation.
It would be great to hear more about patient care and experience in your COM. Please could you describe your COM’s patient care philosophy and approach? How does your COM measure patient satisfaction and outcomes?
The disease of obesity is very complex. That is why we want to offer a therapeutic approach with individualised therapy, which can include behavioural and/or surgical treatment options. In terms of measuring patient satisfaction and outcomes, there is a standardized quality management system for all patients at the University Hospital, which helps take into account patient opinions and feedback. Patients with obesity are also invited to voluntarily complete feedback surveys at regular intervals about their satisfaction with the treatment program. We are still gathering and processing this feedback using these questionnaires, but we look forward to seeing the results.
Please share a recent clinical case, describe relevant challenges and how your team addressed and/or solved them in your COM.
We recently received a request from a concerned relative, seeking treatment for her family member. Unfortunately, direct communication with the potential patient was challenging initially due to mental health restrictions. Additionally, the potential patient lives approximately 100 kilometres away, living independently with a young child and no other family support. The relative, who also lives several hundred kilometres away, highlighted the absence of a family doctor. When we started treatment, it was clear that the patient faced significant challenges around mobility, with a BMI of over 105, and had to use a specialised transport managed by the fire department. To accommodate our patient and make them comfortable, our COM ordered specialised beds, wheelchairs, and positioning cushions for the next clinic appointments. The COM team also had to react quickly to increase support and obesity management offered to the patient, as initially between the 1st and 2nd appointments the patient’s body weight increased. To do this, the COMs team actively worked more closely and intensively with other Medical Center departments, including endoscopy and central patient management. This case has led us to begin work on a new standard operating procedure (SOP) for the care of patients with severe obesity. In the meantime, the patient could no longer live in her flat and moved to an assisted living residence, without her child. As there was a lot of important but technical information about the upcoming bariatric surgery, to ensure not to overwhelm the patient with the mass of information, our COM always communicated important instructions for nutrition directly with the residence staff where the patient lives. We also ensure all telephone appointments with the patient are organized with support from a nurse who works in their residence. We attempted to involve the patient’s family doctor by reaching out to her, and asked our Professor for Internal Medicine to support our case by calling the family doctor and sending letters. Finally, we were able to help the patient successfully by working together with the family doctor, nursing service, physiotherapists and our COM team.
Please share a scientific paper that has had a major impact on your COM team in the last 12 months, and describe how it has impacted your COM activities.
Two papers inspired research activity at our COM: one by Ahlquist et al. 2018 (Paper 1) and the other by Raverdy et al. 2022 (Paper 2). These papers encouraged us to perform a novel cluster analysis using data from our behavioural weight management program, we referring to the cluster analyses performed by Ahlquist et al. 2018 (Paper 1) and Raverdy et al. 2022 (Paper 2). These two excellent publications inspired us to perform a novel cluster analysis using data collected from patients in our COM’s behavioural weight management program, which helped us investigate how differential allocation to obesity management clusters predicted the success of therapy in the behavioural weight management program. The results of our research were presented in a poster by Schlögl et al. 2023 at the annual meeting of the European Association for the Study of Diabetes (EASD).
References
Paper 1: Ahlqvist, E., Storm, P., Käräjämäki, A., Martinell, M., Dorkhan, M., Carlsson, A., … & Groop, L. (2018). Novel subgroups of adult-onset diabetes and their association with outcomes: a data-driven cluster analysis of six variables. The lancet Diabetes & endocrinology, 6(5), 361-369.
Paper 2: Raverdy, V., Cohen, R. V., Caiazzo, R., Verkindt, H., Petry, T. B. Z., Marciniak, C., … & Pattou, F. (2022). Data-driven subgroups of type 2 diabetes, metabolic response, and renal risk profile after bariatric surgery: a retrospective cohort study. The Lancet Diabetes & Endocrinology, 10(3), 167-176.