Influence of bariatric surgery on the use of medication

Eur J Clin Pharmacol. 2016 Feb;72(2):203-9. doi: 10.1007/s00228-015-1971-3. Epub 2015 Nov 3.

Abstract

Purpose: Bariatric surgery can influence the prevalence and incidence of comorbidities, as well as the pharmacokinetics of drugs. This might lead to changes in the use of drugs. This study aimed to assess the influence of bariatric surgery on the use of medication in patients before and after surgery, focusing on type, number of medications, and daily dosage.

Methods: In a retrospective and prospective observational study, drug dispensing data from pharmacies of patients undergoing their first bariatric surgery between January 2008 and September 2011 was collected. Dispensing data from 1 month before until 12 months after surgery was analyzed. Drugs were classified according to the WHO-ATC classification system. Dosages of drugs were compared using defined daily dose (DDD).

Results: Among 450 patients, 12 months after surgery, the mean number of drugs per patient for antidiabetics, drugs acting on the cardiovascular system, anti-inflammatory and antirheumatic drugs, and drugs for obstructed airway diseases decreased by, respectively, 71.3 % (95 % CI 57.2 to 85.4), 34.5 % (95 % CI 28.2 to 43.0), 45.5 % (95 % CI 13.3 to 72.6), and 33.1 % (95 % CI 15.3 to 53.2). Patients used lower median DDD of oral antidiabetics, beta-blocking agents, and lipid-modifying drugs.

Conclusions: For some major drug classes 12 months after bariatric surgery, the use of drugs decreases in terms of mean number per patient. A reduction in dose intensity was observed for oral antidiabetics, beta-blocking agents, and lipid-modifying drugs. Dispensing data from pharmacies may provide detailed information on the use of medications by patients after bariatric surgery.

Keywords: Bariatric surgery; Defined daily dose; Dispensing data; Medication use.

Publication types

  • Observational Study

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Adult
  • Anti-Inflammatory Agents / therapeutic use
  • Antirheumatic Agents / therapeutic use
  • Bariatric Surgery*
  • Cardiovascular Agents / therapeutic use
  • Drug Utilization / statistics & numerical data*
  • Female
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Lipid Regulating Agents / therapeutic use
  • Male
  • Middle Aged
  • Netherlands
  • Pharmacies / statistics & numerical data*

Substances

  • Adrenergic beta-Antagonists
  • Anti-Inflammatory Agents
  • Antirheumatic Agents
  • Cardiovascular Agents
  • Hypoglycemic Agents
  • Lipid Regulating Agents