Respiratory medication prescriptions before and after bariatric surgery

Background: Increased body mass index is associated with asthma and frequent respiratory complaints. Bariatric surgery often results in rapid weight loss associated with an improved respiratory status. Objective: To assess whether patients undergoing bariatric surgery would have fewer respiratory symptoms after surgery as evidenced by decreases in respiratory prescription drug claims. Methods: A retrospective cohort of 320 patients continuously enrolled in a large, southeast Michigan health maintenance organization were studied for 1 year before and 1 year after bariatric surgery. The health maintenance organization claims database was used to compare respiratory prescriptions filled before and after surgery. Respiratory medications included bronchodilator inhalers, inhaled corticosteroids, oral corticosteroids, theophylline, and leukotriene antagonists. Results: Of 320 surgical patients, 64 (20%) filled at least 1 respiratory medication prescription for a total of 468 prescriptions during the 2-year observation period. Of the prescriptions filled, 35% were beta-agonists, 38% inhaled corticosteroids, 12% oral corticosteroids, 15% leukotriene antagonists, and less than 1% theophylline. Total respiratory medication prescription fills decreased by 49% (from 314 to 154 prescriptions) in the postsurgical year, with only 43.1% of patients filling prescriptions in the year before surgery also filling a prescription in the postsurgical surveillance period. Analyses restricted to 40 patients with physician-diagnosed asthma revealed mean (SD) presurgical prescription fills of 7.0 (6.9) per year, decreasing to 3.8 (6.1) per year in the postsurgical year (P = .002). Conclusion: Respiratory medication use decreases significantly after bariatric surgery. A secondary benefit of bariatric surgery may include a decrease in respiratory symptoms and concomitant medication use. Ann Allergy Asthma Immunol. 2010;104:326-330.