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

A four stage process was used involving: Expert consensus; the selection of appropriate measures; A patient cohort over two years; A resource analysis

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

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