Asthma medication usage is significantly reduced following bariatric surgery.

Guerron, Alfredo D; Ortega, Camila B; Lee, Hui-Jie; Davalos, Gerardo; Ingram, Jennifer; Portenier, Dana

Asthma medication usage is significantly reduced following bariatric surgery.

dc.contributor.author	Guerron, Alfredo D
dc.contributor.author	Ortega, Camila B
dc.contributor.author	Lee, Hui-Jie
dc.contributor.author	Davalos, Gerardo
dc.contributor.author	Ingram, Jennifer
dc.contributor.author	Portenier, Dana
dc.date.accessioned	2022-07-01T15:11:48Z
dc.date.available	2022-07-01T15:11:48Z
dc.date.issued	2019-06
dc.date.updated	2022-07-01T15:11:47Z
dc.description.abstract	Introduction Asthma is an important healthcare problem affecting millions in the United States. Additionally, a large proportion of patients with asthma suffer from obesity. These patients exhibit poor asthma control and reduced therapy response, increasing utilization of healthcare resources. Pulmonary symptoms improve after bariatric surgery (BS), and we hypothesized that asthma medication usage would decrease following BS. Methods A retrospective data analysis was performed in adult patients from a single institution's database. Patients with obesity using at least one asthma medication pre-operatively who underwent BS were studied for up to 3-years post-operation. Poisson generalized linear mixed models for repeated measures were used to evaluate the effects of time and procedure type on the number of asthma medication. Results Bariatric patients with at least one prescribed asthma medication (mean 1.4 ± 0.6) were included (n = 751). The mean age at time of operation was 46.8 ± 11.6 years, mean weight was 295.9 ± 57 lbs, and mean body mass index (BMI) was 49 ± 8.2 kg/m²; 87.7% were female, 33.4% had diabetes, 44.2% used gastroesophageal reflux disease (GERD) medication, and 64.4% used hypertension medication. The most common procedure was Roux-en-Y gastric bypass (79%), followed by sleeve gastrectomy (10.7%), adjustable gastric banding (8.1%), and duodenal switch (2.3%). The mean number of prescribed asthma medications among all procedures decreased by 27% at 30 days post-operation (p < 0.0001), 37% at 6 months (p < 0.0001), 44% at 1 year (p < 0.0001), and 46% at 3 years (p < 0.0001) after adjusting for risk factors. No significant differences in medication use over time between procedure types were observed. In the adjusted analysis, the mean number of asthma medications was 12% higher in patients using at least one GERD medication (p = 0.015) and 8% higher with 10-unit increase in pre-operative BMI (p = 0.006). Conclusion BS significantly decreases asthma medication use starting 30 days post-operation with a sustained reduction for up to 3 years.
dc.identifier	10.1007/s00464-018-6500-x
dc.identifier.issn	0930-2794
dc.identifier.issn	1432-2218
dc.identifier.uri	https://hdl.handle.net/10161/25441
dc.language	eng
dc.publisher	Springer Science and Business Media LLC
dc.relation.ispartof	Surgical endoscopy
dc.relation.isversionof	10.1007/s00464-018-6500-x
dc.subject	Humans
dc.subject	Asthma
dc.subject	Obesity, Morbid
dc.subject	Weight Loss
dc.subject	Anti-Asthmatic Agents
dc.subject	Body Mass Index
dc.subject	Retrospective Studies
dc.subject	Adult
dc.subject	Middle Aged
dc.subject	Female
dc.subject	Male
dc.subject	Bariatric Surgery
dc.title	Asthma medication usage is significantly reduced following bariatric surgery.
dc.type	Journal article
duke.contributor.orcid	Guerron, Alfredo D\|0000-0002-4632-1681
duke.contributor.orcid	Ingram, Jennifer\|0000-0002-5269-8864
pubs.begin-page	1967
pubs.end-page	1975
pubs.issue	6
pubs.organisational-group	Duke
pubs.organisational-group	School of Medicine
pubs.organisational-group	Faculty
pubs.organisational-group	Clinical Science Departments
pubs.organisational-group	Medicine
pubs.organisational-group	Pathology
pubs.organisational-group	Surgery
pubs.organisational-group	Medicine, Pulmonary, Allergy, and Critical Care Medicine
pubs.organisational-group	Surgery, Metabolic and Weight Loss Surgery
pubs.organisational-group	Surgery, Surgical Sciences
pubs.publication-status	Published
pubs.volume	33