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DOI: 10.1055/s-0041-1735689
68 Influence of bariatric surgery on antidiabetic medications: An analysis of health insurance data in the context of the ACHT project-Obesity Care and Health Therapy
Zusammenfassung
Our analysis shows that metabolic-bariatric surgery leads to a relevant reduction in antidiabetic medications and their costs in everyday care. However, 3-year follow-up data is limited in this data set leading to wide confidence intervals. Mixed models help estimate mean costs and number of medications, but a higher number of patients would be preferable for estimates. With the introduction of the structured ACHT-program, other important aspects of care, such as access to local medical follow-up, psychological support and quality of life, will be evaluated.
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Einleitung
Metabolic-bariatric surgery is the best evidence-based treatment for morbid obesity, especially if presenting with type 2 diabetes mellitus. ACHT is a project funded by the Innovation Fund of the G-BA to evaluate a structured postoperative follow-up program for patients insured by the AOK-Bayern. The objective of this analysis is to evaluate the baseline situation regarding changes in medication before and after bariatric surgery prior to the start of the ACHT study.
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Material und Methodik
Based on insurance data from AOK-Bayern of patients who had bariatric surgery between 2016 and July, 2019 (n=1269), the effect of bariatric surgery on diabetes medications was evaluated. Medications costs and number of medications in the half-year before surgery were compared to values at 1.5 years and 3 years after surgery. Overall, 87% of patients had medication information available before and after surgery. Since 54% of patients had their operation in 2018 and 2019, only 44% of patients have medication data at 1.5 years after surgery and only 10% have data on medications 3 years after surgery. Thus, mixed regression models were used to account for differences in follow-up time and these were adjusted for age, sex, repeated measurements and data distribution.
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Ergebnisse
We analyzed data of 1100 operated patients of which 31% received diabetes medications in the 0.5-years before surgery, 13% 1.5-years after surgery and 12% 3-years after surgery. Mean costs and number of diabetes medications were highest in the 0.5-years before surgery (301 € (95% CI: 244€; 370€) with an average of 3.0 drugs (95% CI: 2.6; 3.4)). These values significantly decreased to 54€ (33€; 87€) and 0.61 (0.46; 0.81) at 1.5-years and 51€ (33€; 87€) and 0,40 (0.21; 0.75) at 3-years, respectively, after surgery.
Adipositas-Komorbiditäten und Komplikationen
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Publication History
Article published online:
24 September 2021
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