Dillon Carla, Peddle Justin, Twells Laurie, Lester Kendra, Midodzi William, Manning Kimberley, Murphy Raleen, Pace David, Smith Chris, Boone Darrell, Gregory Deborah
BScPharm, ACPR, PharmD, is with the School of Pharmacy and Faculty of Medicine, Memorial University of Newfoundland, St John's, Newfoundland and Labrador.
BScPharm, PharmD, is with the School of Pharmacy, Memorial University of Newfoundland, St John's, Newfoundland and Labrador.
Can J Hosp Pharm. 2015 Mar-Apr;68(2):113-20. doi: 10.4212/cjhp.v68i2.1436.
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.
To determine whether patients took fewer medications for management of type 2 diabetes, hypertension, and dyslipidemia after laparoscopic sleeve gastrectomy, relative to preprocedure medications.
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.
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.
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.
接受减肥手术的患者通常需要更少的药物，因为他们的各种疾病状况得到改善甚至解决，包括2型糖尿病、高血压和血脂异常。腹腔镜袖状胃切除术是一种越来越受欢迎的减肥手术，关于该手术后药物使用变化的已发表数据有限。
确定与术前用药相比，腹腔镜袖状胃切除术后患者用于治疗2型糖尿病、高血压和血脂异常的药物是否减少。
在这项前瞻性单中心队列研究中，一名执业护士使用标准药物核对和研究数据提取表对接受腹腔镜袖状胃切除术的成年患者进行访谈，以确定他们的用药情况和相关人口统计学数据。使用广义估计方程和标准统计软件对数据进行分析。结果指标包括术后1、3和6个月时抗糖尿病、抗高血压和抗血脂药物使用的变化。
2011年5月至2014年1月期间，共有65例接受腹腔镜袖状胃切除术的患者符合研究纳入标准。术前，30例2型糖尿病患者平均服用1.9种抗糖尿病药物。术后1个月，15例（50%）停用了所有抗糖尿病药物，在3个月和6个月时进一步减少（每个时间点p<0.001）。术前服用抗高血压药（n = 48）和抗血脂药（n = 33）的患者中，用药减少的速度较为缓慢，分别有6例（12%）和2例（6%）在1个月内停用这些药物类别，到6个月时分别有12例（25%）（p = 0.001）和8例（24%）（p = 0.015）停用。
这些发现表明，有2型糖尿病、高血压和/或血脂异常病史且接受腹腔镜袖状胃切除术的患者在术后短期内不太可能需要特定疾病的药物。
