Impact of Bariatric Surgery on Medication Efficacy: an Analysis of World Health Organization Pharmacovigilance Data

Guigui, Alicia; Bétry, Cécile; Khouri, Charles; Borel, Anne‐Laure

doi:10.1007/s11695-021-05258-4

Cited by 2 publications

(3 citation statements)

References 9 publications

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“…Several reviews illustrate that the pharmacokinetics of drugs can change as a consequence of bariatric surgery [ 3 – 6 ], leading to adjusted drug dosing advice. A recent report also described pharmacovigilance signals showing changes in drug efficacy and adverse drug reactions after bariatric surgery [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Patients with bariatric surgery: Urgent need for accurate registration of the contraindication to enable safe pharmacotherapy in hospital and primary care

Lau

Sbaa²,

Smeenk³

et al. 2022

Eur J Clin Pharmacol

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Purpose To enable the use of automatic clinical decision support for pharmacotherapy in patients with bariatric surgery, it is necessary to register the contraindication “bariatric surgery” in the hospital, general practitioner (GP), and community pharmacy electronic health record systems. The aim of this research was to quantify the correct registration of this contraindication in hospital, GP, and community pharmacy records. Furthermore, we investigated whether the registration status in primary care was dependent on the registration status in the hospital. Methods From patients who underwent bariatric procedures performed in the Albert Schweitzer Hospital (Dordrecht, the Netherlands) between 2018 and 2021, the percentage of registered contraindications in hospital medical records was assessed. Due to feasibility reasons, a subset of the patients’ data was created for assessing the percentage of registered contraindications in GP and community pharmacy records. Results Out of 664 patients who underwent bariatric surgery, the contraindication bariatric surgery was registered in 69.1% of the cases. Out of 552 patients, 28.3% and 25.1% were correctly registered in GP and community pharmacy records, respectively. There was no correlation between registration status in the hospital EHR and registration status in GP practices or community pharmacies. Conclusions The percentage of correct registration of bariatric surgery in hospital, GP, and community pharmacies is low. To avoid doctors prescribing and pharmacists dispensing drugs to post-bariatric patients without knowing that they have undergone this procedure, better registration of the contraindication is required to enable optimal use of clinical decision support systems for the pharmacotherapy of patients after bariatric surgery.

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Section: Introductionmentioning

confidence: 99%

Patients with bariatric surgery: Urgent need for accurate registration of the contraindication to enable safe pharmacotherapy in hospital and primary care

Lau

Sbaa²,

Smeenk³

et al. 2022

Eur J Clin Pharmacol

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“…A recent analysis reported on the worldwide documented pharmacovigilance signals associated with MBS. In this report, pharmacovigilance signals involving 165 drug reports and 128 patients were described [ 5 ]. Most signals were about Roux-en-Y gastric bypass patients (77%) and described drug ineffectiveness (75%).…”

Section: Introductionmentioning

confidence: 99%

“…Most signals were about Roux-en-Y gastric bypass patients (77%) and described drug ineffectiveness (75%). This low number of 165 drug reports up to 2020 globally may reflect either a low clinical impact of MBS or an underreporting of modified effects [ 5 ]. In other words, healthcare professionals may not report adverse events, complications, or reduced drug efficacy attributed to MBS.…”

Section: Introductionmentioning

confidence: 99%

A Dutch Survey on Medication Adjustments after Metabolic and Bariatric Surgery: Experiences of Bariatric Surgeons, Internists, Pharmacists, and General Practitioners

Lau,

van Kesteren,

Smeenk

2024

OBES SURG

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Background 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. Methods 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. Results 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. Conclusions 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. Graphical Abstract

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Impact of Bariatric Surgery on Medication Efficacy: an Analysis of World Health Organization Pharmacovigilance Data

Cited by 2 publications

References 9 publications

Patients with bariatric surgery: Urgent need for accurate registration of the contraindication to enable safe pharmacotherapy in hospital and primary care

Patients with bariatric surgery: Urgent need for accurate registration of the contraindication to enable safe pharmacotherapy in hospital and primary care

A Dutch Survey on Medication Adjustments after Metabolic and Bariatric Surgery: Experiences of Bariatric Surgeons, Internists, Pharmacists, and General Practitioners

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