Abstract
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. Longitudinal study of before-and-after type, on 69 morbidly obese patients in a public hospital in Porto Alegre. Through interviews, the presence of comorbidities and use of drugs with and without prescription were evaluated. 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. 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.
Highlights
Chronic non-communicable diseases are one of the biggest public health issues today.[1]
More than half of all Brazilians (51%) are overweight, and 17% of these individuals are obese.[1]. Fighting this rapid growth is one of the biggest challenges for world health, given that obesity is frequently associated with a vast array of comorbidities, such as systemic arterial hypertension, type 2 diabetes mellitus, dyslipidemia, obstructive sleep apnea, cardiovascular diseases and some types of cancer.[4,5,6,7,8]
Studies assessing drug use and their respective dosages after bariatric surgery are still scarce. Within this context, this study aimed to assess the impact of bariatric surgery on medication drug use among morbidly obese patients, before and after the procedure, focusing mainly on the number of drugs used, drug classes and posology. This was a longitudinal study of before-and-after type, carried out between 2008 and 2011 in the endocrinology clinic of the service for assisting morbidly obese individuals at Hospital Nossa Senhora da Conceição (HNSC) in the city of Porto Alegre, which works under the National Health System (Sistema Único de Saúde, SUS)
Summary
Chronic non-communicable diseases are one of the biggest public health issues today.[1] Obesity stands out in this regard and has been officially acknowledged by the World Health Organization (WHO) as a chronic disease.[2]. The number of obese individuals has been increasing worldwide and has reached an average of 30% of the adult population in some countries.[3] In Brazil, poor dietary habits have been reflected in the population’s health and in increasing prevalence of overweight. More than half of all Brazilians (51%) are overweight, and 17% of these individuals are obese.[1]. Fighting this rapid growth is one of the biggest challenges for world health, given that obesity is frequently associated with a vast array of comorbidities, such as systemic arterial hypertension, type 2 diabetes mellitus, dyslipidemia, obstructive sleep apnea, cardiovascular diseases and some types of cancer.[4,5,6,7,8] Most patients with high blood pressure are overweight,[9] and hypertension is six times more frequent among obese individuals than among those with normal weight.[10]
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