Department of Clinical Pharmacy, Albert Schweitzer Hospital, Dordrecht, The Netherlands.
Department of Pharmacy and Pharmacology, Antoni Van Leeuwenhoek Hospital/The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Obes Surg. 2024 May;34(5):1778-1785. doi: 10.1007/s11695-024-07197-2. Epub 2024 Apr 2.
As metabolic and bariatric surgery (MBS) can alter the pharmacokinetics of drugs, post-bariatric surgery patients may require medication adjustments and monitoring. To improve pharmacotherapy in these patients, we aimed to understand the beliefs, attitudes, knowledge, and concerns of healthcare professionals who treat these patients.
A survey by means of an online questionnaire was divided into six sections. It was sent to bariatric surgeons, internists, pharmacists, and general practitioners in the Netherlands.
Out of 229 returned surveys, 222 were included. Virtually all respondents (98%) expected MBS to influence the effect of medication. Both reduced efficacy (23%) and more adverse events or medication-related complications (21%) were recognized. Two-thirds of the respondents felt competent to prescribe or to provide advice regarding medication in post-bariatric surgery patients. Most of the respondents (95%) believed that other healthcare professionals should be aware of the contraindication "bariatric surgery". Of the respondents, 37% indicated that they were not aware of the medication advice incorporated in the electronic health record systems. Almost half of the respondents (48%) indicated that they documented changes in drug effects. Most respondents answered that these ought to be registered in the pharmacovigilance database or national registry.
The majority of prescribers and pharmacists believe that patients will receive better pharmacotherapy if healthcare professionals take MBS into account. However, not all prescribers think they are competent to act adequately. To improve this, information on changed drug effects after MBS should be more widely shared among healthcare professionals via resources that are easily accessible.
由于代谢和减重手术（MBS）会改变药物的药代动力学，因此减重手术后的患者可能需要调整药物剂量并进行监测。为了改善这些患者的药物治疗，我们旨在了解治疗这些患者的医疗保健专业人员的信念、态度、知识和关注点。
通过在线问卷调查进行调查，该问卷分为六个部分。它被发送给荷兰的减重外科医生、内科医生、药剂师和全科医生。
在 229 份返回的调查中，有 222 份被纳入。几乎所有受访者（98%）都预计 MBS 会影响药物的疗效。大家都认识到药物疗效降低（23%）和更多的不良反应或与药物相关的并发症（21%）。三分之二的受访者认为自己有能力为减重手术后的患者开处方或提供药物建议。大多数受访者（95%）认为其他医疗保健专业人员应该意识到“减重手术”的禁忌症。在受访者中，37%的人表示他们不知道电子健康记录系统中包含的药物建议。近一半的受访者（48%）表示他们记录了药物作用的变化。大多数受访者回答说，这些变化应该在药物警戒数据库或国家登记册中进行登记。
大多数开处方者和药剂师认为，如果医疗保健专业人员考虑到 MBS，患者将接受更好的药物治疗。然而，并非所有开处方者都认为他们有能力充分发挥作用。为了改善这种情况，应通过医疗保健专业人员容易获得的资源，更广泛地共享有关 MBS 后药物作用变化的信息。
