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Prescription drug usage as measure of comorbidity resolution after bariatric surgery: a population-based cohort study

  • 2023 SAGES Oral
  • Published:
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Abstract

Background

Obesity is a chronic and progressive disease associated with significant morbidity, mortality, and health-care costs. Bariatric surgery is the most effective intervention for sustainable weight loss and resolution of obesity-related comorbidities. Studies examining comorbidity resolution largely rely on individual self-reported outcomes and electronic record reviews. We present a population-based study looking at prescription medication utilization before and after bariatric surgery as a measure of comorbidity resolution.

Methods

All patients enrolled in the Center for Metabolic and Bariatric Surgery who underwent either gastric bypass or sleeve gastrectomy between 2013 and 2019 in Manitoba were included. Demographic information, follow up, and outpatient prescription dispensation data were obtained from the Manitoba Population Research Data Repository housed at the Manitoba Centre for Health Policy for 5 years pre- and post-surgery.

Results

A total of 1184 patients were included. Antidepressants and selective serotonin reuptake inhibitors were the most commonly prescribed classes, and along with thyroid medication, utilization remained stable after bariatric surgery. Proton pump inhibitors and opioid class drugs increased at 1 year after surgery then returned to baseline. Glucose and lipid-lowering medications, including statins, biguanides, sulfonylureas, and insulin, were decreased. Antihypertensives, including ACE inhibitors, calcium channel blockers, angiotensin receptors blockers, thiazides, and beta blockers, similarly decreased.

Conclusion

This is the first Canadian study employing a provincial-wide prescription database to measure long-term comorbidity resolution after bariatric surgery. The use of administrative data eliminates potential biases and inaccuracies in follow up and self-reported outcomes. Consistent with the literature, prescriptions for the treatment of metabolic syndrome all decreased and were sustained at long-term follow up. Further studies are needed to delineate the effects of altered pharmaceutical utilization on patient quality of life and health-care expenditures.

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Acknowledgements

This research project was funded by a GFT (Geographical Full Time) grant provided by the University of Manitoba (UM 323268). The authors acknowledge the Manitoba Centre for Health Policy for use of data contained in the Manitoba Population Research Data Repository under project # 2021-002 (HIPC # 2020/2021-18). The results and conclusions are those of the authors and no official endorsement by the Manitoba Centre for Health Policy or Manitoba Health is intended or should be inferred. Data used in this study are from the Manitoba Population Research Data Repository housed at the Manitoba Centre for Health Policy, University of Manitoba and were derived from data provided by Manitoba Health.

Funding

This research project was funded by a GFT (Geographical Full Time) grant provided by the University of Manitoba (UM 323268).

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Authors and Affiliations

  1. Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada

    Ted Chia Hao Wu, Wenjing He, Ashley Vergis & Krista Hardy

  2. Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada

    Isuru Dharmasena & Heather J. Prior

  3. Department of Surgery, Max Rady College of Medicine, Boniface General Hospital, University of Manitoba, Z3039 – 409 Tache Avenue, St., Winnipeg, MB, R2H 2A6, Canada

    Ashley Vergis

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  1. Ted Chia Hao Wu
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Correspondence to Ashley Vergis.

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Ashley Vergis is a hernia proctor for Becton Dickinson. Ted Chia Hao Wu, Wenjing He, Isuru Dharmasena, Heather J Prior, Krista Hardy has no disclosure or conflicts of interests. The authors have no disclosures or conflicts of interests related to the results in this publication.

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Wu, T.C.H., He, W., Dharmasena, I. et al. Prescription drug usage as measure of comorbidity resolution after bariatric surgery: a population-based cohort study. Surg Endosc 37, 8601–8610 (2023). https://doi.org/10.1007/s00464-023-10294-5

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