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13.10.2022 | Original Contributions

Drug-Related Problems in Bariatric Surgery: a Retrospective Study

verfasst von: Yuping Wang, Jie Zhu, Luchen Shan, Cunchuan Wang, Zhiyong Dong, Wah Yang, Chinese Obesity and Metabolic Surgery Collaborative

Erschienen in: Obesity Surgery | Ausgabe 12/2022

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Abstract

Background

With the rapid increase of bariatric surgery worldwide, drug-related problems (DRPs) in this area seem to be rising. This study aimed to investigate the incidence and characteristics of DRPs in patients undergoing bariatric surgery.

Methods

Medication records for patients who underwent bariatric surgery were analysed retrospectively between January 2019 and December 2020 in our center. We classified and analysed DRPs using the Pharmaceutical Care Network Europe classification (PCNE version 9.0). Rating severity of these DRPs was based on the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) classification. Continuous variables were analysed by Student’s t-test, and categorical variables were compared using the chi-square test. One-way ANOVA was used to compare the numbers of DRPs.

Results

Totally 347 patients were reviewed, and 760 DRPs were identified with an average of 2.19 ± 1.36 DRPs for each patient. The most common DRPs were problems related to perioperative antibiotics accounting for 29.47%, 25.62% and 14.34% for hepatoprotection and proton-pump inhibitors (PPI), respectively. The leading causes of DRPs were inappropriate medications for antibiotics, hepatoprotection, ancillary drugs and PPI. 89.34% of the DRPs were rated at severity categories B-D (which means potential adverse reactions that may occur), whereas 10.66% were rated as categories E–H. There were relations between DRPs and older (32.22 ± 9.29 vs. 29.11 ± 6.53 years), fewer concomitant surgeries (1.89 ± 1.25 vs. 2.99 ± 1.31), longer postoperative fasting time (PFT) (1.18 ± 0.55 vs. 1.06 ± 0.24 days) and more comorbidities (6.71 ± 2.63 vs. 5.23 ± 1.46) (P < 0.05).

Conclusions

The incidence of DRPs in the perioperative period of bariatric surgery is high. Patients with fewer concomitant surgeries and longer PFT are prone to DRPs. It is necessary for clinical pharmacists to participate in medication monitoring and reviewing to facilitate enhanced recovery after bariatric surgery.

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Literatur
1.
Zurück zum Zitat NCDRF Collaboration. Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults. Lancet. 2017;390(10113):2627–42.CrossRef NCDRF Collaboration. Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults. Lancet. 2017;390(10113):2627–42.CrossRef
2.
Zurück zum Zitat Pan XF, Wang L, Pan A. Epidemiology and determinants of obesity in China. Lancet Diabetes Endocrinol. 2021;9(6):373–92.CrossRefPubMed Pan XF, Wang L, Pan A. Epidemiology and determinants of obesity in China. Lancet Diabetes Endocrinol. 2021;9(6):373–92.CrossRefPubMed
3.
Zurück zum Zitat Smit C, De Hoogd S, Bruggemann RJM, et al. Obesity and drug pharmacology: a review of the influence of obesity on pharmacokinetic and pharmacodynamic parameters. Expert Opin Drug Met. 2018;14(3):275–85.CrossRef Smit C, De Hoogd S, Bruggemann RJM, et al. Obesity and drug pharmacology: a review of the influence of obesity on pharmacokinetic and pharmacodynamic parameters. Expert Opin Drug Met. 2018;14(3):275–85.CrossRef
4.
Zurück zum Zitat Green B, Duffull SB. What is the best size descriptor to use for pharmacokinetic studies in the obese? Brit J Clin Pharmaco. 2004;58(2):119–33.CrossRef Green B, Duffull SB. What is the best size descriptor to use for pharmacokinetic studies in the obese? Brit J Clin Pharmaco. 2004;58(2):119–33.CrossRef
5.
Zurück zum Zitat Yang W, Zhu S, Cheng Z, et al. Laparoscopic Roux-en-Y gastric bypass for excess weight and diabetes: a multicenter retrospective cohort study in China. Mini-invasive Surg. 2021;5:11 Yang W, Zhu S, Cheng Z, et al. Laparoscopic Roux-en-Y gastric bypass for excess weight and diabetes: a multicenter retrospective cohort study in China. Mini-invasive Surg. 2021;5:11
6.
Zurück zum Zitat De Jong A, Verzilli D, Chanques G, et al. Preoperative risk and perioperative management of obese patients. Rev Mal Respir. 2019;36(8):985–1001. Risque pre-operatoire et gestion peri-operatoire des patients obeses. De Jong A, Verzilli D, Chanques G, et al. Preoperative risk and perioperative management of obese patients. Rev Mal Respir. 2019;36(8):985–1001. Risque pre-operatoire et gestion peri-operatoire des patients obeses.
7.
Zurück zum Zitat Skues MA. Perioperative management of the obese ambulatory patient. Curr Opin Anesthesio. 2018;31(6):693–9.CrossRef Skues MA. Perioperative management of the obese ambulatory patient. Curr Opin Anesthesio. 2018;31(6):693–9.CrossRef
8.
Zurück zum Zitat Coulson EE, Kral LA. The clinical pharmacist’s role in perioperative surgical pain management. J Pain Palliat Care Pharmacother. 2020;34(3):120–6.CrossRefPubMed Coulson EE, Kral LA. The clinical pharmacist’s role in perioperative surgical pain management. J Pain Palliat Care Pharmacother. 2020;34(3):120–6.CrossRefPubMed
9.
Zurück zum Zitat Nguyen AD, Lam A, Banakh I, et al. Improved medication management with introduction of a perioperative and prescribing pharmacist service. J Pharm Pract. 2020;33(3):299–305.CrossRefPubMed Nguyen AD, Lam A, Banakh I, et al. Improved medication management with introduction of a perioperative and prescribing pharmacist service. J Pharm Pract. 2020;33(3):299–305.CrossRefPubMed
10.
Zurück zum Zitat Strand LM, Morley PC, Cipolle RJ, et al. Drug-related problems: their structure and function. DICP. 1990;24(11):1093–7.CrossRefPubMed Strand LM, Morley PC, Cipolle RJ, et al. Drug-related problems: their structure and function. DICP. 1990;24(11):1093–7.CrossRefPubMed
12.
Zurück zum Zitat Shamliyan TA, Kane RL. Drug-related harms in hospitalized Medicare beneficiaries: results from the healthcare cost and utilization project, 2000–2008. J Patient Saf. 2016;12(2):89–107.CrossRefPubMed Shamliyan TA, Kane RL. Drug-related harms in hospitalized Medicare beneficiaries: results from the healthcare cost and utilization project, 2000–2008. J Patient Saf. 2016;12(2):89–107.CrossRefPubMed
13.
Zurück zum Zitat Saedder EA, Brock B, Nielsen LP, et al. Identifying high-risk medication: a systematic literature review. Eur J Clin Pharmacol. 2014;70(6):637–45.CrossRefPubMed Saedder EA, Brock B, Nielsen LP, et al. Identifying high-risk medication: a systematic literature review. Eur J Clin Pharmacol. 2014;70(6):637–45.CrossRefPubMed
14.
Zurück zum Zitat Hoonhout LHF, de Bruijne MC, Wagner C, et al. Nature, occurrence and consequences of medication-related adverse events during hospitalization: a retrospective chart review in the Netherlands. Drug Saf. 2010;33(10):853–64.CrossRefPubMed Hoonhout LHF, de Bruijne MC, Wagner C, et al. Nature, occurrence and consequences of medication-related adverse events during hospitalization: a retrospective chart review in the Netherlands. Drug Saf. 2010;33(10):853–64.CrossRefPubMed
15.
Zurück zum Zitat Hailu BY, Berhe DF, Gudina EK, et al. Drug related problems in admitted geriatric patients: the impact of clinical pharmacist interventions. Bmc Geriatr. 2020;20(1) Hailu BY, Berhe DF, Gudina EK, et al. Drug related problems in admitted geriatric patients: the impact of clinical pharmacist interventions. Bmc Geriatr. 2020;20(1)
16.
Zurück zum Zitat Pfister B, Jonsson J, Gustafsson M. Drug-related problems and medication reviews among old people with dementia. Bmc Pharmacol Toxico. 2017;18 Pfister B, Jonsson J, Gustafsson M. Drug-related problems and medication reviews among old people with dementia. Bmc Pharmacol Toxico. 2017;18
17.
Zurück zum Zitat Rodriguez de Castro B, Martinez-Mugica Barbosa C, Pampin Sanchez R, et al. Dosage of presurgical cefazolin in obese and non-obese patients. Does weight matter? Rev Esp Quimioter. 2020;33(3):207–11. Dosificacion de cefazolina prequirurgica en pacientes obesos y no obesos. inverted question markImporta el peso? Rodriguez de Castro B, Martinez-Mugica Barbosa C, Pampin Sanchez R, et al. Dosage of presurgical cefazolin in obese and non-obese patients. Does weight matter? Rev Esp Quimioter. 2020;33(3):207–11. Dosificacion de cefazolina prequirurgica en pacientes obesos y no obesos. inverted question markImporta el peso?
18.
Zurück zum Zitat Chen X, Brathwaite CEM, Barkan A, et al. Optimal cefazolin prophylactic dosing for bariatric surgery: no need for higher doses or intraoperative redosing. Obes Surg. 2017;27(3):626–9.CrossRefPubMed Chen X, Brathwaite CEM, Barkan A, et al. Optimal cefazolin prophylactic dosing for bariatric surgery: no need for higher doses or intraoperative redosing. Obes Surg. 2017;27(3):626–9.CrossRefPubMed
19.
Zurück zum Zitat Bratzler DW, Dellinger EP, Olsen KM, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Surg Infect (Larchmt). 2013;14(1):73–156.CrossRef Bratzler DW, Dellinger EP, Olsen KM, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Surg Infect (Larchmt). 2013;14(1):73–156.CrossRef
20.
Zurück zum Zitat Stenberg E, Dos Reis Falcao LF, O’Kane M, et al. Guidelines for perioperative care in bariatric surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations: A 2021 Update. World J Surg. 2022;46(4):729–51.CrossRefPubMedPubMedCentral Stenberg E, Dos Reis Falcao LF, O’Kane M, et al. Guidelines for perioperative care in bariatric surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations: A 2021 Update. World J Surg. 2022;46(4):729–51.CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Bamgbade OA, Oluwole O, Khaw RR. Perioperative antiemetic therapy for fast-track laparoscopic bariatric surgery. Obes Surg. 2018;28(5):1296–301.CrossRefPubMed Bamgbade OA, Oluwole O, Khaw RR. Perioperative antiemetic therapy for fast-track laparoscopic bariatric surgery. Obes Surg. 2018;28(5):1296–301.CrossRefPubMed
22.
Zurück zum Zitat Collares-Pelizaro RVA, Santos JS, Nonino CB, et al. Omeprazole absorption and fasting gastrinemia after Roux-en-Y gastric bypass. Obes Surg. 2017;27(9):2303–7.CrossRefPubMed Collares-Pelizaro RVA, Santos JS, Nonino CB, et al. Omeprazole absorption and fasting gastrinemia after Roux-en-Y gastric bypass. Obes Surg. 2017;27(9):2303–7.CrossRefPubMed
23.
Zurück zum Zitat Guang Du, Zhao J, Shuhong Bu, et al. Expert consensus on rational drug use of aerosol inhalation therapy(2019 edition). Herald Med. 2019;38(02):135–46. Guang Du, Zhao J, Shuhong Bu, et al. Expert consensus on rational drug use of aerosol inhalation therapy(2019 edition). Herald Med. 2019;38(02):135–46.
24.
Zurück zum Zitat Che G, Qifei Wu, Qiu Y, et al. Chinese expert consensus on multidisciplinary perioperative airway management (2018 edition). Chin J Clin Thorac Cardiov Surg. 2018;25(07):545–9. Che G, Qifei Wu, Qiu Y, et al. Chinese expert consensus on multidisciplinary perioperative airway management (2018 edition). Chin J Clin Thorac Cardiov Surg. 2018;25(07):545–9.
28.
Zurück zum Zitat Qu C, Meng L, Wang N, et al. Identify and categorize drug-related problems in hospitalized surgical patients in China. Int J Clin Pharm-Net. 2019;41(1):13–7.CrossRef Qu C, Meng L, Wang N, et al. Identify and categorize drug-related problems in hospitalized surgical patients in China. Int J Clin Pharm-Net. 2019;41(1):13–7.CrossRef
29.
Zurück zum Zitat Meng L, Qu C, Qin X, et al. Drug-related problems among hospitalized surgical elderly patients in China. Biomed Res Int. 2021;2021. Meng L, Qu C, Qin X, et al. Drug-related problems among hospitalized surgical elderly patients in China. Biomed Res Int. 2021;2021.
30.
Zurück zum Zitat Schroder S, Zollner YF, Schaefer M. Drug related problems with antiparkinsonian agents: consumer Internet reports versus published data. Pharmacoepidem Dr S. 2007;16(10):1161–6. PubMed PMID: WOS:000250430400016. English. Schroder S, Zollner YF, Schaefer M. Drug related problems with antiparkinsonian agents: consumer Internet reports versus published data. Pharmacoepidem Dr S. 2007;16(10):1161–6. PubMed PMID: WOS:000250430400016. English.
31.
Zurück zum Zitat Al-Azzam SI, Alzoubi KH, AbuRuz S, et al. Drug-related problems in a sample of outpatients with chronic diseases: a cross-sectional study from Jordan. Ther Clin Risk Manag. 2016;12:233–9.CrossRefPubMedPubMedCentral Al-Azzam SI, Alzoubi KH, AbuRuz S, et al. Drug-related problems in a sample of outpatients with chronic diseases: a cross-sectional study from Jordan. Ther Clin Risk Manag. 2016;12:233–9.CrossRefPubMedPubMedCentral
32.
Zurück zum Zitat Garin N, Sole N, Lucas B, et al. Drug related problems in clinical practice: a cross-sectional study on their prevalence, risk factors and associated pharmaceutical interventions. Sci Rep-Uk. 2021;11(1) Garin N, Sole N, Lucas B, et al. Drug related problems in clinical practice: a cross-sectional study on their prevalence, risk factors and associated pharmaceutical interventions. Sci Rep-Uk. 2021;11(1)
33.
Zurück zum Zitat Jia DX, Lu WQ, Zhang XR, et al. Calf Spleen Extractive Injection (CSEI), a small peptides enriched extraction, induces human hepatocellular carcinoma cell apoptosis via ROS/MAPKs dependent mitochondrial pathway. J Pharmacol Sci. 2016;132(2):122–30.CrossRefPubMed Jia DX, Lu WQ, Zhang XR, et al. Calf Spleen Extractive Injection (CSEI), a small peptides enriched extraction, induces human hepatocellular carcinoma cell apoptosis via ROS/MAPKs dependent mitochondrial pathway. J Pharmacol Sci. 2016;132(2):122–30.CrossRefPubMed
34.
Zurück zum Zitat Adibe MO, Igboeli NU, Ukwe CV. Evaluation of drug therapy problems among renal patients receiving care in some tertiary hospitals in Nigeria. Trop J Pharm Res. 2017;16(3):697–704.CrossRef Adibe MO, Igboeli NU, Ukwe CV. Evaluation of drug therapy problems among renal patients receiving care in some tertiary hospitals in Nigeria. Trop J Pharm Res. 2017;16(3):697–704.CrossRef
35.
Zurück zum Zitat Guan XD, Tian Y, Song JFF, et al. Effect of physicians’ knowledge on antibiotics rational use in China’s county hospitals. Soc Sci Med. 2019;224:149–55.CrossRefPubMed Guan XD, Tian Y, Song JFF, et al. Effect of physicians’ knowledge on antibiotics rational use in China’s county hospitals. Soc Sci Med. 2019;224:149–55.CrossRefPubMed
36.
Zurück zum Zitat Wushouer H, Wang ZF, Tian Y, et al. The impact of physicians’ knowledge on outpatient antibiotic use Evidence from China’s county hospitals. Medicine. 2020;99(3) Wushouer H, Wang ZF, Tian Y, et al. The impact of physicians’ knowledge on outpatient antibiotic use Evidence from China’s county hospitals. Medicine. 2020;99(3)
37.
Zurück zum Zitat Hussain Z, Curtain C, Mirkazemi C, et al. Prophylactic cefazolin dosing and surgical site infections: does the dose matter in obese patients? Obes Surg. 2019;29(1):159–65.CrossRefPubMed Hussain Z, Curtain C, Mirkazemi C, et al. Prophylactic cefazolin dosing and surgical site infections: does the dose matter in obese patients? Obes Surg. 2019;29(1):159–65.CrossRefPubMed
38.
Zurück zum Zitat Hussain Z, Curtain C, Mirkazemi C, et al. Peri-operative medication dosing in adult obese elective surgical patients: a systematic review of clinical studies. Clin Drug Invest. 2018;38(8):673–93.CrossRef Hussain Z, Curtain C, Mirkazemi C, et al. Peri-operative medication dosing in adult obese elective surgical patients: a systematic review of clinical studies. Clin Drug Invest. 2018;38(8):673–93.CrossRef
39.
Zurück zum Zitat Blum S, Cunha CB, Cunha BA. Lack of pharmacokinetic basis of weight-based dosing and intra-operative re-dosing with cefazolin surgical prophylaxis in obese patients: Implications for antibiotic stewardship. Surg Infect. 2019;20:439–43.CrossRef Blum S, Cunha CB, Cunha BA. Lack of pharmacokinetic basis of weight-based dosing and intra-operative re-dosing with cefazolin surgical prophylaxis in obese patients: Implications for antibiotic stewardship. Surg Infect. 2019;20:439–43.CrossRef
40.
Zurück zum Zitat Mitrov-Winkelmolen L, van Buul-Gast MCW, Swank DJ, et al. The effect of Roux-en-Y gastric bypass surgery in morbidly obese patients on pharmacokinetics of (acetyl) salicylic acid and omeprazole: the ERY-PAO study. Obes Surg. 2016;26(9):2051–8.CrossRefPubMed Mitrov-Winkelmolen L, van Buul-Gast MCW, Swank DJ, et al. The effect of Roux-en-Y gastric bypass surgery in morbidly obese patients on pharmacokinetics of (acetyl) salicylic acid and omeprazole: the ERY-PAO study. Obes Surg. 2016;26(9):2051–8.CrossRefPubMed
41.
Zurück zum Zitat Thereaux J, Lesuffleur T, Czernichow S, et al. Do sleeve gastrectomy and gastric bypass influence treatment with proton pump inhibitors 4 years after surgery? A nationwide cohort. Surg Obes Related Dis. 2017;13(6):951–9.CrossRef Thereaux J, Lesuffleur T, Czernichow S, et al. Do sleeve gastrectomy and gastric bypass influence treatment with proton pump inhibitors 4 years after surgery? A nationwide cohort. Surg Obes Related Dis. 2017;13(6):951–9.CrossRef
Metadaten
Titel
Drug-Related Problems in Bariatric Surgery: a Retrospective Study
verfasst von
Yuping Wang
Jie Zhu
Luchen Shan
Cunchuan Wang
Zhiyong Dong
Wah Yang
Chinese Obesity and Metabolic Surgery Collaborative
Publikationsdatum
13.10.2022
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 12/2022
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-022-06295-3

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