Association of Bariatric Surgery and National Medication Use

Morton, John M.; Ponce, Jaime; Malangone-Monaco, Elisabetta; Nguyen, Ninh T.

doi:10.1016/j.jamcollsurg.2018.10.021

Cited by 16 publications

(10 citation statements)

References 34 publications

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“…Bariatric surgery reduced postoperative pharmacy use and costs compared with a propensity‐matched, nonsurgical control group during a 4‐year follow‐up period (98).…”

Section: Resultsmentioning

confidence: 99%

Benefits of weight loss of 10% or more in patients with overweight or obesity: A review

Tahrani

Morton

2022

Obesity

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Obesity is a multifactorial chronic disease that is associated with increased risks of type 2 diabetes (T2D), cardiovascular disease, certain cancers, sleep apnea, subfertility, and mortality, among other complications (1). For adults, the World Health Organization (WHO) defines "overweight" and "obesity" as having BMI of 25 kg/m 2 or more and 30 kg/m 2 or more, respectively (2). According to WHO estimates, almost four in ten adults (39%) were overweight and more than one in ten (13%) had obesity in 2016 globally (2). As BMI does not reflect fat distribution, waist circumference provides further information about patient risks of T2D, hypertension, and cardiovascular disease, which increase with increasing BMI and waist circumference category (Table 1) (1). Risks of comorbidities and cutoff points for considering therapeutic intervention differ in Asian versus non-Asian populations, with BMI of 23 to 27.5 kg/m 2 conferring increased risk and BMI of 27.5 kg/m 2 or more conferring high risk in Asian individuals (3). Members of Black and some minority ethnic groups are also at increased risk of chronic health conditions at a lower BMI than the White population (BMI < 25 kg/m 2 ) (4).The global prevalence of obesity almost tripled between 1975 and 2016 (2), and it is increasingly becoming a public health priority.Overweight and obesity are responsible for a substantial disease burden and are associated with considerable direct costs (e.g., health care expenditure) and indirect costs (e.g., loss of productivity and gross domestic product [GDP]) (5,6). In 2014, 5% of deaths worldwide were attributable to obesity (7). Health expenditure associated with overweight/obesity is estimated to account for 2% to 8% of total health expenditure, although these values may be underestimates (5).Overweight and obesity and their consequences also negatively affect

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“…Bariatric surgery reduced postoperative pharmacy use and costs compared with a propensity‐matched, nonsurgical control group during a 4‐year follow‐up period (98).…”

Section: Resultsmentioning

confidence: 99%

Benefits of weight loss of 10% or more in patients with overweight or obesity: A review

Tahrani

Morton

2022

Obesity

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“…However, the prevalence of claims-measured chronic conditions at baseline were modest but in alignment with other populations [ 52 , 53 ]. It is possible that program-induced lifestyle changes did not result in a large enough weight change to see short-term changes in these measures as compared with more extreme weight loss efforts such as weight loss medication or surgery [ 54 ]. It is also possible that these metrics may have shown subsequent improvement following weight loss rather than in parallel with weight loss (e.g., change from 12 to 24 months post-program enrollment rather than from 0 to 12 months post-enrollment).…”

Section: Discussionmentioning

confidence: 99%

Pragmatic Evaluation of a Health System-Based Employee Weight Management Program

Dinh

Rivard

Herrmann

et al. 2021

IJERPH

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Objective: We aimed to evaluate the fidelity and estimate the effectiveness of a novel health system employee weight-management program. Methods: Employees participating in a weight loss program consisting of self-monitoring, health coaching and meal replacements optionally enrolled in the 12-month study. Longitudinal, single-arm analyses were conducted evaluating change over time via survey, claims and programmatic data. Token participation incentives were offered for survey completion. Results: In total, 140 participants enrolled (51.2 ± 9.8 years; BMI = 33.2 ± 6.5 kg/m2; 89.3% female). During 1 year, participants attended 18.0 ± 12.2 coaching appointments and self-reported significant improvements in weight (−8.2 ± 10.5% body weight), BMI (−3.9 ± 6.5 kg/m2), fruit/vegetable intake, home food preparation, added sugar, sugar sweetened beverages and life satisfaction (all p < 0.05). No significant changes were reported in physical activity, weight-related social support, self-efficacy or healthcare utilization (all p > 0.05). Conclusions: The findings from this evaluation establish implementation fidelity. Clinically significant self-reported weight loss, coupled with improvements in many weight-related behaviors, suggest the program is an effective weight management tool when offered as an employee well-being program.

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“…First, although we had access to all publicly funded RYGB procedures and comprehensive administrative databases showing all publicly funded health care expenditures in Ontario, it is likely that we underestimated the financial advantages of these surgical bariatric procedures because we did not account for savings in prescribed medications after the procedure. For example, a recent US study reported that 4-year postoperative pharmacy costs were significantly lower among 2700 patients who underwent the surgical bariatric intervention compared with 2700 matched control individuals (US $8411 vs $9900; P < .001) . In Ontario, prescribed medications are reimbursed by the Ontario Ministry of Health and Long-Term Care for older adults and social assistance recipients only, whereas other Canadian citizens are covered by private insurance or pay out-of-pocket.…”

Section: Discussionmentioning

confidence: 99%

Association of Roux-en-Y Gastric Bypass With Postoperative Health Care Use and Expenditures in Canada

et al. 2020

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IMPORTANCEResults of previous studies are mixed regarding the economic implications of a Roux-en-Y gastric bypass (RYGB).OBJECTIVE To assess the 5-year incremental health care use and expenditures after RYGB. DESIGN, SETTING, AND PARTICIPANTSThis population-based cohort study conducted in Ontario, Canada, used a difference-in-differences approach to compare health care use and expenditures between patients who underwent a publicly funded RYGB from March 1, 2010, to March 31, 2013, and propensity score-matched control individuals who did not undergo a surgical bariatric procedure. The study period allowed for a minimum 60 months of follow-up because, at that time, the most recent date for which administrative data on health care and expenditures were available was March 31, 2018. Data sources included the Ontario Bariatric Registry linked to several Ontario health administrative databases and the Electronic Medical Record Administrative Data Linked Database. Health care use and expenditures data for 5 years before and 5 years after the index date (procedure date for RYGB group; random date for controls) were analyzed. Data analyses were performed March 12, 2019, to March 10, 2020.INTERVENTION RYGB procedure. MAIN OUTCOMES AND MEASURESThe primary outcome was total health care expenditures. RESULTS The final propensity score-matched cohorts comprised 1587 individuals in the RYGB group (mean [SD] age, 47 [10.2] years) and 1587 controls (mean [SD] age, 47 [12.2] years); each group had 1228 women (77.4%) and a mean body mass index (calculated as weight in kilograms divided by height in meters squared) of 46. Mean total health care expenditures (2017 Canadian dollars

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Association of Bariatric Surgery and National Medication Use

Cited by 16 publications

References 34 publications

Benefits of weight loss of 10% or more in patients with overweight or obesity: A review

Benefits of weight loss of 10% or more in patients with overweight or obesity: A review

Pragmatic Evaluation of a Health System-Based Employee Weight Management Program

Association of Roux-en-Y Gastric Bypass With Postoperative Health Care Use and Expenditures in Canada

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