Current projects

ACHT – Adipositas Care & Health Therapy for structured, cross–discipline and cross-sector care after bariatric-metabolic surgery

Project team

R. Leidl, M. Laxy, R. Stark

Project sponsor

The project is sponsored by a Grant from the Innovation Committee of the Joint Federal Committee, Grant number 01NVF18023

Consortium leader

German Foundation for the chronically ill, Dr. Thomas M. Helms, Dr. Bettina Zippel-SchultzGerman Foundation for the chronically ill, Dr. Thomas M. Helms, Dr. Bettina Zippel-Schultz

Consortium partners

University Clinic Würzburg : Interdisciplinary Obesity Center (Prof. Dr. M. Fassnacht, PD Dr. F. Seyfried); Obesity Center of Clinic    Memmingen (Dr. H. Schlosser); Surgical Clinic Munich-Bogenhausen (  Prof. Dr. T. Hüttl); Schön Clinic Nürnberg Fürth (Prof. Dr. T.    Horbach);  Surgical center of the Wolfart clinic, Munich-Gräfelfing   (PD Dr. G.  Meyer); RoMed Clinic Bad Aibling Obesity Center (PD   Dr. S. Schopf);  Clinic for general-, visceral- and thoracic surgery   Clinic Nurnberg North  (Prof. Dr. U. Hesse); Clinic for general-,  visceral-, thoracic-, vascular- und  pediatric surgery of the city of   Passau (Dr. K. E. Gerauer); Institute for health economics and    healthcare management at the Helmholtz Zentrum  München (Prof.   Dr. R. Leidl., Dr. R. Stark); symeda GmbH (Dr. N.  Hellrung); AOK   Bayern - Die Gesundheitskasse (P. Krase); Association of    Statutory Health Insurance Physicians of Bavaria (Dr. W. Krombholz);   German Association for general and visceral surgery (Pr   of. Dr. H.-J. Buhr)

Project length

42 Months, until 31.12.2022

Brief description

Severely obese people who fail to achieve adequate weight loss with conventional therapies can be effectively treated with bariatric metabolic surgery. However, therapeutic success requires lifelong medical follow-up. Since usual care does not provide structured. 

Goals

The goal of ACHT ("Obesity Care & Health Therapy") is to establish a digitally supported, structured, cross-sectoral, close-to-home follow-up program for patients after bariatric surgery. This should improve quality  of life of patients.

Concept

The care concept in ACHT consists of eight interlocking components:

   1) structured, close-to-home medical follow-up in specially trained ACHT medical practices,
   2) regular nutritional advice,
   3) individually defined exercise goals by a sports physician,
   4) supervision by an obesity case manager,
   5 ) a digital case file for exchanging information between involved medical personnel,  
   6) a patient app linked to the case file to document daily goal achievement,
   7) psychological stabilization of patients and
   8) data exchange with the StuDoQ quality assurance database.

These measures should ensure that possible complications are avoided or recognized early.

The eight components of the care concept of ACHT:

Patients will be recruited for an 18-month program.
One patient group will receive an early intervention and start the program shortly after bariatric surgery.
Another patient group will receive a late intervention and will start the program 18 months after surgery.
Both intervention groups are compared at the end of the program with controls who are 18 months and 36 months after bariatric surgery.
Study schedule and overview of intervention and control groups
The primary endpoint of the study is an improvement in the general health of patients as measured by the modified King’s Score. This is measured and evaluated in the intervention and control groups.

Secondary endpoints:

1. Improved quality of life,
2. Improved mood (reduction of depression).

Other endpoints:

individual dimensions of the King’s Score, complications of bariatric metabolic surgery (dumping syndrome, symptoms of nutritional deficiency), patient satisfaction, sick days.
Process evaluation of the following parameters: patient adherence (compliance with follow-up, adherence to treatment), effects on the structure of medical care (establishment of the patient app, exchange of information between medical caregivers with the help of the digital case file), strengthening the follow-up structures in the outpatient sector, ensuring close-to-home medical care, satisfaction with the follow-up care concept.
Economic evaluation will examine costs of medical care based on health insurance data, costs of the program and will compare medical costs and effects.