Is Bariatric Surgery Effective in Reducing Comorbidities and Drug Costs? A Systematic Review and Meta-Analysis

Lopes, Edyane Cardoso; Heineck, Isabela; Athaydes, Genaro Azambuja; Meinhardt, Nelson Guardiola; Souto, Kátia Elisabete Pires; Stein, Airton Tetelbom

doi:10.1007/s11695-015-1777-5

Cited by 50 publications

(46 citation statements)

References 33 publications

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“…Importantly, the features of the population and the follow-up period need to be taken into account in assessing these proportions, because the impact of surgery on antidiabetic drug use may vary according to these factors. 29 The great majority of the patients with type 2 diabetes experience more favorable results from clinical examinations, after undergoing bariatric surgery. The mortality rate associated with diabetes has also been significantly reduced.…”

Section: Antidiabetic Drugsmentioning

confidence: 99%

Medication and nutritional supplement use before and after bariatric surgery

Backes

Lopes²,

Tetelbom

et al. 2016

Sao Paulo Med. J.

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CONTEXT AND OBJECTIVE: Bariatric surgery has been an effective alternative treatment for morbid obesity and has resulted in decreased mortality, better control over comorbidities and reduced use of drugs. The objective of this study was to analyze the impact of bariatric surgery on medication drug and nutritional supplement use. DESIGN AND SETTING: Longitudinal study of before-and-after type, on 69 morbidly obese patients in a public hospital in Porto Alegre. METHODS: Through interviews, the presence of comorbidities and use of drugs with and without prescription were evaluated. RESULTS: Among the 69 patients interviewed, 85.5% had comorbidities in the preoperative period, with an average of 2.3 (± 1.5) per patient. The main comorbidities reported were hypertension, diabetes and dyslipidemia. 84.1% of the patients were using prescribed drugs in the preoperative period. The mean drug use per patient was 4.8, which decreased to 4.4 after the procedure. The surgery enabled significant reduction in use of most antidiabetic (84%), antilipemic (77%) and antihypertensive drugs (49.5%). On the other hand, there was a significant increase in use of multivitamins and drugs for disorders of the gastrointestinal tract. The dosages of most of the drugs that continued to be prescribed after surgery were decreased, but not significantly. CONCLUSION: After bariatric surgery, there were increases in the use of vitamins, gastric antisecretory drugs and antianemic drugs. Nevertheless, there was an overall reduction in drug use during this period, caused by suspension of drugs or dose reduction. RESUMO CONTEXTO E OBJETIVO:A cirurgia bariátrica tem sido uma alternativa efetiva de tratamento para a obesidade mórbida, resultando na diminuição da mortalidade, melhor controle das comorbidades e redução no uso de medicamentos. O objetivo deste estudo foi analisar o impacto da cirurgia bariátrica sobre a utilização de medicamentos e suplementos nutricionais. TIPO DE ESTUDO E LOCAL: Estudo longitudinal do tipo antes e depois com 69 pacientes obesos mórbi-dos em um hospital público de Porto Alegre. MÉTODOS: Nas entrevistas, foram avaliados a presença de comorbidades e o uso de medicamentos com e sem prescrição médica. RESULTADOS: De 69 pacientes entrevistados, 85,5% apresentaram comorbidades no período pré-cirúrgi-co, média de 2,3 (± 1,5) por paciente. As principais comorbidades relatadas foram hipertensão, diabetes e dislipidemias. 84,1% dos pacientes estavam em uso de medicamentos sob prescrição médica, no período pré-cirúrgico. A média de uso de medicamentos por paciente foi de 4,8, reduzindo para 4,4 após o procedimento. A cirurgia proporcionou diminuição significativa do uso da maioria dos antidiabéticos (84%), antilipêmicos (77%) e anti-hipertensivos (49,5%). Por outro lado, observou-se aumento significativo na utilização de multivitamínicos e medicamentos para desordens do trato gastrointestinal. A maior parte dos medicamentos que continuaram sendo prescritos após a cirurgia teve sua dose reduzida, no entanto, esta redução nã...

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Section: Antidiabetic Drugsmentioning

confidence: 99%

Medication and nutritional supplement use before and after bariatric surgery

Backes

Lopes²,

Tetelbom

et al. 2016

Sao Paulo Med. J.

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“…Bariatric surgery is the most effective treatment for morbid obesity, resulting in a significant decrease in weight, as well as amelioration of associated co‐morbidities including type 2 diabetes mellitus (T2DM), cardiovascular diseases, obstructive sleep apnoea and musculoskeletal disorders. A decrease in the number of co‐morbidities may lead to a reduction in the healthcare resources associated with managing severe and complex obesity.…”

Section: Introductionmentioning

confidence: 99%

Systematic review of risk prediction models for diabetes after bariatric surgery

Zhang¹,

Borisenko²,

Telegina³

et al. 2016

Journal of British Surgery

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Systematic review of risk prediction models for diabetes after bariatric surgeryZhang, R.; Borisenko, O.; Telegina, I.; Hargreaves, J.; Ahmed, A. R.; Sanchez Santos, R.; Pring, C.; Funch-Jensen, P.; Dillemans, B.; Hedenbro, Jan General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal Take down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.

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“…21 22 Indeed, a recent meta-analysis, comprising 37 720 patients across 11 studies, showed that bariatric surgery significantly reduces drug use and costs. 23 In addition, the direct treatment of obesity would likely help to reduce the burden on physicians who spend a substantial amount of time treating the comorbidities associated with obesity. The value of preventative strategies for obesity is an important consideration for decision makers, particularly given the increasing concern over the sustainability of the healthcare system and the ageing population.…”

Section: Discussionmentioning

confidence: 99%

Healthcare usage and economic impact of non-treated obesity in Italy: findings from a retrospective administrative and clinical database analysis

et al. 2017

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ObjectivesInvestigate the prevalence of obesity in Italy and examine its resource consumption and economic impact on the Italian national healthcare system (NHS).DesignRetrospective, observational and real-life study.SettingData from three health units from Northern (Bergamo, Lombardy), Central (Grosseto, Tuscany) and Southern (Naples, Campania) Italy.ParticipantsAll patients aged ≥18 years with at least one recorded body mass index (BMI) measurement between 1 January 2009 and 31 December 2012 were included.InterventionsInformation retrieved from the databases included primary care data, medical prescriptions, specialist consultations and hospital discharge records from 2009–2013. Costs associated with these data were also calculated. Data are presented for two time periods (1 year after BMI measurement and study end).Primary and secondary outcome measuresPrimary—to estimate health resources consumption and the associated economic impact on the Italian NHS. Secondary—the prevalence and characteristics of subjects by BMI category.Results20 159 adult subjects with at least one documented BMI measurement. Subjects with BMI ≥30 kg/m2 were defined as obese. The prevalence of obesity was 22.2% (N=4471) and increased with age. At the 1-year observation period, obese subjects who did not receive treatment for their obesity experienced longer durations of hospitalisation (median length: 5 days vs 3 days), used more prescription drugs (75.0% vs 57.7%), required more specialised outpatient healthcare (mean number: 5.3 vs 4.4) and were associated with greater costs, primarily owing to prescription drugs and hospital admissions (mean annual cost per year per patient: €460.6 vs €288.0 for drug prescriptions, €422.7 vs € 279.2 for hospitalisations and €283.2 vs €251.7 for outpatient care), compared with normal weight subjects. Similar findings were observed for the period up to data cut-off (mean follow-up of 2.7 years).ConclusionsUntreated obesity has a significant economic impact on the Italian healthcare system, highlighting the need to raise awareness and proactively treat obese subjects.

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Is Bariatric Surgery Effective in Reducing Comorbidities and Drug Costs? A Systematic Review and Meta-Analysis

Cited by 50 publications

References 33 publications

Medication and nutritional supplement use before and after bariatric surgery

Medication and nutritional supplement use before and after bariatric surgery

Systematic review of risk prediction models for diabetes after bariatric surgery

Healthcare usage and economic impact of non-treated obesity in Italy: findings from a retrospective administrative and clinical database analysis

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