Rapid Reduction in Use of Antidiabetic Medication after Laparoscopic Sleeve Gastrectomy: The Newfoundland and Labrador Bariatric Surgery Cohort (BaSCo) Study.

Autor:	Dillon C; BScPharm, ACPR, PharmD, is with the School of Pharmacy and Faculty of Medicine, Memorial University of Newfoundland, St John's, Newfoundland and Labrador., Peddle J; BScPharm, PharmD, is with the School of Pharmacy, Memorial University of Newfoundland, St John's, Newfoundland and Labrador., Twells L; BA, MSc, PhD, is with the School of Pharmacy and Faculty of Medicine, Memorial University of Newfoundland, St John's, Newfoundland and Labrador., Lester K; BSc, MSc, is with the Faculty of Medicine, Memorial University of Newfoundland, St John's, Newfoundland and Labrador., Midodzi W; PhD, is with the Faculty of Medicine, Memorial University of Newfoundland, St John's, Newfoundland and Labrador., Manning K; RN, is with Eastern Health, St John's, Newfoundland and Labrador., Murphy R; NP, MSc(A), BSc, is with Eastern Health, St John's, Newfoundland and Labrador., Pace D; BSc, MBA, MD, FRCSC, is with Eastern Health and the Faculty of Medicine, Memorial University of Newfoundland, St John's, Newfoundland and Labrador., Smith C; BSc(Hons), MD, FRCSC, is with Eastern Health and the Faculty of Medicine, Memorial University of Newfoundland, St John's, Newfoundland and Labrador., Boone D; BMedSc, MD, FRCSC, is with Eastern Health and the Faculty of Medicine, Memorial University of Newfoundland, St John's, Newfoundland and Labrador., Gregory D; BN, MSc, PhD, is with the Faculty of Medicine, Memorial University of Newfoundland, St John's, Newfoundland and Labrador.
Jazyk:	angličtina
Zdroj:	The Canadian journal of hospital pharmacy [Can J Hosp Pharm] 2015 Mar-Apr; Vol. 68 (2), pp. 113-20.
DOI:	10.4212/cjhp.v68i2.1436
Abstrakt:	Background: Patients who have undergone bariatric surgery generally need fewer medications as they experience improvement in, or even resolution of, various medical conditions, including type 2 diabetes mellitus, hypertension, and dyslipidemia. Published data on changes in medication use after laparoscopic sleeve gastrectomy, a type of bariatric surgery that is growing in popularity, are limited. Objective: To determine whether patients took fewer medications for management of type 2 diabetes, hypertension, and dyslipidemia after laparoscopic sleeve gastrectomy, relative to preprocedure medications. Methods: In this prospective, single-centre cohort study, a nurse practitioner used standard medication reconciliation and study data-extraction forms to interview adult patients who had undergone laparoscopic sleeve gastrectomy and determine their medication use and pertinent demographic data. The data were analyzed using generalized estimating equations and standard statistical software. Outcome measures included changes in the use of antidiabetic, antihypertensive, and antilipemic medications at 1, 3, and 6 months after the surgery. Results: A total of 65 patients who underwent laparoscopic sleeve gastrectomy between May 2011 and January 2014 met the study inclusion criteria. Before surgery, the 30 patients with type 2 diabetes were taking an average of 1.9 antidiabetic medications. One month after the procedure, 15 (50%) had discontinued all antidiabetic medications, with a further decline at 3 and 6 months (p < 0.001 at each time point). Among the patients who were taking antihypertensives (n = 48) and antilipemics (n = 33) before surgery, the decline in use occurred at a more modest rate, with 6 (12%) and 2 (6%), respectively, discontinuing these medication classes within 1 month, and 12 (25%) (p = 0.001) and 8 (24%) (p = 0.015) having discontinued by 6 months. Conclusions: These findings suggest that patients with a history of type 2 diabetes mellitus, hypertension, and/or dyslipidemia who undergo laparoscopic sleeve gastrectomy are less likely to require disease-specific medications shortly after surgery.
Databáze:	MEDLINE
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