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

## TL;DR

This Dutch survey explores how healthcare professionals adjust medications after bariatric surgery and highlights the need for better communication and resources.

## Contribution

The study provides insights into the knowledge, attitudes, and practices of healthcare professionals regarding medication adjustments after bariatric surgery.

## Key findings

- Most professionals believe MBS affects medication efficacy and safety.
- Only two-thirds feel competent to adjust medications for post-surgery patients.
- There is a call for better sharing of drug effect changes after MBS among professionals.

## Abstract

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.

The online version contains supplementary material available at 10.1007/s11695-024-07197-2.