Medication use following bariatric surgery: factors associated with early discontinuation.
BACKGROUND
Medication discontinuation is a common result of bariatric surgery. The influence of individual patient characteristics and surgical outcomes on overall and specific medication discontinuation is not well understood. The purpose of the current study was to assess changes in medication use and identify individual characteristics and surgical outcomes associated with medication discontinuation among bariatric patients.


METHODS
The patients included in the current study received bariatric surgery from the Northern Colorado Surgical Associates of Fort Collins, Colorado, USA, between October 2007 and September 2010. Demographic, weight, health, and medication data from 400 patients with at least one 6- or 12-month post-operative appointment were extracted from the Bariatric Outcome Longitudinal Database. Multivariate regression analyses were used to investigate how patient factors affect total medication use over time, use of medications grouped by co-morbidity post-operatively, and use of specific medication classes post-operatively.


RESULTS
Baseline co-morbidities, particularly type 2 diabetes,male sex, and Roux-en-Y gastric bypass surgery were significantly associated with decreased total medication use following surgery.Weight loss, systemic disease, sex, baseline co-morbidities, surgical complications, and race were significantly associated with continued use of specific medications following surgery.


CONCLUSIONS
Bariatric surgery can help patients with certain characteristics discontinue medications but is not effective for all patients. Baseline health, sex, race, bariatric procedure,surgical complications, and post-operative weight loss may affect how bariatric patients' medication use changes preoperatively to post-operatively.
Amy L
AL
Kennedy
Tracy
T
Nelson
Stefan
S
Pettine
Benjamin F
BF
Miller
Karyn L
KL
Hamilton
Elise L
EL
Donovan
D000293:Adolescent; D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000008:administration & dosage; D000959:Antihypertensive Agents / Q000008:administration & dosage; D050110:Bariatric Surgery; D015897:Comorbidity; D003863:Depression / Q000188:drug therapy / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy / Q000517:prevention & control; D006973:Hypertension / Q000188:drug therapy / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D000960:Hypolipidemic Agents / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011788:Quality of Life; D012074:Remission Induction; D016896:Treatment Outcome; D015431:Weight Loss
D000928:Antidepressive Agents; D000959:Antihypertensive Agents; D007004:Hypoglycemic Agents; D000960:Hypolipidemic Agents