Medication Use Among Patients Prior to Bariatric Surgery

Abstract

The aims of this study were to describe the most common medications reported by candidates for weight loss surgery and to consider the potential implications for patient care. A secondary data analysis of data from bariatric surgery patients enrolled in a randomized, controlled trial. At study entry, participants recorded their use of prescription medications they had taken in the previous 90 days. The Anatomical Therapeutic Chemical (ATC)/Defined Daily Dose (DDD) Index 2014 was used to classify medications. Participants (=265) were 85.7% female and 83.0% white. Mean body mass index was 47.9±6.5 kg/m, and age was 45.1±11 years. The average number of medications was 4.4±4.1, and the median was 3. The top three anatomical main groups were the cardiovascular system, alimentary tract and metabolism, and nervous system (28.2%, 21.6%, and 21.3% of all medications, respectively). The top therapeutic subgroups were drugs used in diabetes, psychoanaleptics, and agents acting on the renin-angiotensin system (12%, 11.3%, and 8.2% of all medications, respectively). Candidates for weight loss surgery report taking medications associated with obesity-related comorbidities such as diabetes, depression, and hypertension. Although many may be able to eliminate these medications, others will require close monitoring and dosage adjustment after surgery.

Association between weight loss and reduced use of antihypertensive, hypoglycemic, psychotropic, and lipid-lowering drugs in patients undergoing bariatric surgery

“…O uso excessivo de fármacos nos obesos mórbidos também já foi estudado por Elliot et al 11 que evidenciaram, em uma maioria de mulheres brancas, um consumo médio diário de 4,4 fármacos, sendo a maioria (28,2%) para o sistema cardiovascular. Não foi possível comparar este achado com o do presente estudo uma vez que poucas classes de fármacos foram estudadas, não sendo incluídos analgésicos, terapia tireoidiana, broncodilatadores, entre outros.…”

“…Entretanto, poucos trabalhos abordaram o tema da redução do uso rotineiro de fármacos associado ao controle metabólico das principais comorbidades, especialmente os hipoglicemiantes, anti-hipertensivos e anti-dislipidêmicos [11][12][13] . O objetivo do presente estudo, portanto, é analisar se a redução de peso observada na cirurgia bariátrica (bypass gástrico em Y de Roux; BGYR) é acompanhada da redução do uso de medicamentos de controle de comorbidades, especificamente o DM2, HAS, DLP, além de psicotrópicos, após 6 e 12 meses.…”

Efficacy of the treatment with dapagliflozin and metformin compared to metformin monotherapy for weight loss in patients with class III obesity: a randomized controlled trial

“…International guidelines suggest the use of drugs for weight loss when BMI is higher than 30 kg/m 2 , but only few have been approved due to their adverse effects, including increased blood pressure, anxiety, tachycardia and psychiatric effects [18]. Patients with severe obesity use a daily average of 4.4 ± 4.1 medications to control comorbidities such as diabetes, including psychoanaleptics and agents acting on the renin-angiotensin system (12%, 11.3%, and 8.2% of all medications, respectively) [19]. Therefore, most patients may not be candidates for some of these weight loss drugs, which will limit their chances to undergo surgery.…”