Yska Jan Peter, van der Meer Douwe H, Dreijer Albert R, Eilander Willeke, Apers Jan A, Emous Marloes, Totté Erik R E, Wilffert Bob, van Roon Eric N
Department of Clinical Pharmacy and Clinical Pharmacology, Medical Centre Leeuwarden, PO Box 888, 8901 BR, Leeuwarden, The Netherlands.
Department of Surgery, Medical Centre Leeuwarden, Leeuwarden, The Netherlands.
Eur J Clin Pharmacol. 2016 Feb;72(2):203-9. doi: 10.1007/s00228-015-1971-3. Epub 2015 Nov 3.
Bariatric surgery can influence the prevalence and incidence of comorbidities, as well as the pharmacokinetics of drugs. This might lead to changes in the use of drugs. This study aimed to assess the influence of bariatric surgery on the use of medication in patients before and after surgery, focusing on type, number of medications, and daily dosage.
In a retrospective and prospective observational study, drug dispensing data from pharmacies of patients undergoing their first bariatric surgery between January 2008 and September 2011 was collected. Dispensing data from 1 month before until 12 months after surgery was analyzed. Drugs were classified according to the WHO-ATC classification system. Dosages of drugs were compared using defined daily dose (DDD).
Among 450 patients, 12 months after surgery, the mean number of drugs per patient for antidiabetics, drugs acting on the cardiovascular system, anti-inflammatory and antirheumatic drugs, and drugs for obstructed airway diseases decreased by, respectively, 71.3 % (95 % CI 57.2 to 85.4), 34.5 % (95 % CI 28.2 to 43.0), 45.5 % (95 % CI 13.3 to 72.6), and 33.1 % (95 % CI 15.3 to 53.2). Patients used lower median DDD of oral antidiabetics, beta-blocking agents, and lipid-modifying drugs.
For some major drug classes 12 months after bariatric surgery, the use of drugs decreases in terms of mean number per patient. A reduction in dose intensity was observed for oral antidiabetics, beta-blocking agents, and lipid-modifying drugs. Dispensing data from pharmacies may provide detailed information on the use of medications by patients after bariatric surgery.
减肥手术可影响合并症的患病率和发病率，以及药物的药代动力学。这可能导致药物使用的变化。本研究旨在评估减肥手术对患者术前和术后用药的影响，重点关注药物类型、用药数量和每日剂量。
在一项回顾性和前瞻性观察研究中，收集了2008年1月至2011年9月期间接受首次减肥手术患者的药房配药数据。分析了手术前1个月至手术后12个月的配药数据。药物根据世界卫生组织药物解剖学治疗学化学分类系统进行分类。使用限定日剂量（DDD）比较药物剂量。
在450名患者中，术后12个月，每位患者用于抗糖尿病药、作用于心血管系统的药物、抗炎和抗风湿药以及气道阻塞性疾病药物的平均用药数量分别减少了71.3%（95%置信区间57.2至85.4）、34.5%（95%置信区间28.2至43.0）、45.5%（95%置信区间13.3至72.6）和33.1%（95%置信区间15.3至53.2）。患者口服抗糖尿病药、β受体阻滞剂和调脂药的中位DDD较低。
减肥手术后12个月，对于一些主要药物类别，每位患者的用药数量有所减少。观察到口服抗糖尿病药、β受体阻滞剂和调脂药的剂量强度降低。药房的配药数据可能提供减肥手术后患者用药的详细信息。
