Medication and nutritional supplement use before and after bariatric surgery

Abstract

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...

Assessment of Bariatric Surgery Patients in Lebanon: A Cross-Sectional Observational Study

“…The results are comparable to Backes et al study in 2016 which revealed that the most common comorbidities during the postoperative phase were hypertension (29.7%), followed by diabetes (6.3%) and dyslipidemia (6.3%) [19]. Unlikely, the percentage of those with hypertension were lower in our study as compared to Backes et al study but diabetes percentage was higher in the Lebanese bariatric population [19].…”

“…Sleeve gastrectomy was the most performed (57.7%) bariatric surgery in our study, followed by roux-eny gastric bypass (27%) and gastric banding (15.3%). Unlikely, in Backes et al study, the surgical technique most often used was gastric bypass (91.4%) [19].…”

“…Backes et al study also revealed a high use of vitamins and minerals by more than half of the participants (56.5%) [19]. As these surgeries pose a high risk of vitamins and minerals deficiencies, such supplements are of extreme importance especially in mal-absorptive procedures.…”

Real-world evidence of health outcomes and medication use 24 months after bariatric surgery in the public healthcare system in Brazil: a retrospective, single-center study

“…There is consistent evidence that surgical treatment of obesity results in more favorable weight loss and weight-associated comorbidity outcomes compared with nonsurgical interventions (1,2), with a positive impact on preexisting diabetes and hypertension, among others (3,4). A lower risk of developing type 2 diabetes (T2D), hypertension, angina, myocardial infarction, and obstructive sleep apnea after bariatric surgery has also been reported (4).…”

“…A lower risk of developing type 2 diabetes (T2D), hypertension, angina, myocardial infarction, and obstructive sleep apnea after bariatric surgery has also been reported (4). The improvement or resolution of comorbidities is likely to entail reduced medication use and expenditure following bariatric surgery (3).…”