Evaluation of prescription medication changes following sleeve gastrectomy surgery

Gina Arena; Alex Kitsos; Jeffrey M Hamdorf; Mike D'Arcy-Evans; Michelle Kilpatrick; Alison Venn; David B Preen

doi:10.1002/osp4.742

Evaluation of prescription medication changes following sleeve gastrectomy surgery

Obes Sci Pract. 2024 Feb 13;10(1):e742. doi: 10.1002/osp4.742. eCollection 2024 Feb.

Authors

Gina Arena¹, Alex Kitsos², Jeffrey M Hamdorf^{3

4}, Mike D'Arcy-Evans⁴, Michelle Kilpatrick², Alison Venn², David B Preen¹

Affiliations

¹ School of Population and Global Health The University of Western Australia Nedlands Western Australia Australia.
² Menzies Institute for Medical Research University of Tasmania Hobart Tasmania Australia.
³ Medical School The University of Western Australia Nedlands Western Australia Australia.
⁴ Western Surgical Health Nedlands Western Australia Australia.

Abstract

Objective: The increasing global prevalence of obesity, coupled with its association with chronic health conditions and rising healthcare costs, highlights the need for effective interventions; however, despite the availability of treatment options, the ongoing success of primary interventions in maintaining long-term weight loss remains limited. This study examined the prescription medication dispensing changes following sleeve gastrectomy in Australians aged 45 years and over.

Methods: In a retrospective analysis of 847 bariatric surgery patients from the New South Wales 45 and Up Study, the assessment of medication patterns categorizing into three groups: gastrointestinal, metabolic, cardiorespiratory, musculoskeletal, and nervous systems was conducted. Each drug class was analyzed, focusing on patients with dispensing records within the 12 months before surgery. This study employed interrupted time-series analysis to compare pre- and post-surgery medication usage.

Results: With a predominantly female population (76.9%) and an average age of 57.2 (standard deviation 5.71), there were statistically significant reductions in both unique medications (12.5% decrease, p = 0.004) and total medications dispensed (15.9% decrease, p = 0.003) from 12 months before surgery to 13-24 months after bariatric surgery. All medication categories, except opioids, showed reductions. Notably, the most significant reductions were observed in diabetes (38.6%), agents acting on the renin-angiotensin system (40.4%), lipid modifying agents (26.5%), anti-inflammatory products (46.3%), and obstructive airway diseases (53.3%) medications during this time frame.

Conclusion: These findings suggest that sleeve gastrectomy provides an effective therapeutic intervention for patients with comorbidities requiring multiple medications, especially for obesity-related diseases such as diabetes, cardiovascular, respiratory and musculoskeletal disorders.

Keywords: bariatric surgery; obesity; prescription utilisation.