What are GLP-1 Agonists?
GLP-1 stands for Glucagon-like peptide-1 receptor. Glucagon-like peptide-1 is naturally secreted from your body after a meal. Since these drugs are agonists, they mimic the actions of GLP-1 secreted naturally from your body. GLP-1 helps with insulin secretion, glucose production and utilization, and arterial blood flow.
How and why are these drugs used?
Most often, these drugs are administered by injection, once per week. They are prescribed for Type 2 diabetes and, more recently, for weight loss.
Why is understanding this drug important in the surgery setting?
Patients that take this class of medications, regardless of the reason, may require additional assessment and a more hands-on approach to the preoperative fasting period. This is because the action of GLP-1 Agonists increases the time that food remains in the stomach, sometimes for days, increasing the risk of aspiration with anesthesia.
How can you determine if a patient is taking a GLP-1 Agonist drug?
The best and most reliable way to determine if a patient is taking a GLP-1 Agonist drug is for the patient to self-report. We have learned from our clients that patients don’t always consider these drugs as a “prescription” and may forget to report it with their list of prescription meds. Also, if they are taking it for weight loss, they may not associate that with a medical condition that needs to be reported. After hearing this feedback from our clients, we have added a new category to our Medication section in Medical Passport asking specifically about drugs for weight-loss. We also have the ability to create a Clinical Significance warning if a patient reports taking GLP-1 Agonists, drugs for weight loss, and a slew of other things, to help give you a heads-up in advance of the day of surgery.
If you are using Medical Passport to complete pre-admission assessments online and you would like to make sure you have these options activated, reach out to your Customer Success Manager. If you are not using Medical Passport to perform your pre-admission assessments, you should evaluate the method you are using and consider whether or not the questions will prompt the patient to self-report and how you are going to filter the assessments so you don’t end up with last-minute cancellations, or worse, an adverse patient outcome.
What are some efficient ways to communicate when a patient should stop the drug prior to surgery?
The next line of defense in preventing patient harm is education. Patients do not always absorb everything that is being said to them at the doctor’s office, especially if it is something serious, like surgery. As a result, it is extremely important to reinforce critical information in the period leading up to surgery. There are numerous ways that our clients work to get the necessary information into the hands of their patients. Mailing packets and making phone calls will work sometimes but with the mail, you have to hope it gets to them in time and that the patient reads it. With phone calls, you have to try and reach the patients when they are probably at work. Using texting and email to communicate is going to give you more tools and opportunities to reach the patient in a way that is more convenient for them and for you. A blanket approach of sending text and email messages regarding GLP-1 Agonist protocols is going to give you the confidence that you have done everything you can to inform patients before surgery.
With our patient communication solution, Engage, it is easy to update messages to patients if your protocols change. If you want to send a message 10 days before surgery to ask patients who are on weekly GLP-1 Agonists to hold for 1 week, you can do that. If you have one physician that would rather have the patients contact them directly, we can use Engage criteria to easily set that up for you.
Links and research for this webinar:
American Society of Anesthesiologists Consensus-Based Guidance on Preoperative Management of Patients (Adults and Children) on Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists | Press Release – 6/29/2023:
https://www.asahq.org/about-asa/newsroom/news-releases/2023/06/american-society-of-anesthesiologists-consensus-based-guidance-on-preoperative
https://www.drugsandalcohol.ie/glossary/info/agonist
https://elsevier.health/en-US/preview/glucagon-like-peptide-1-glp-1-receptor-agonists
https://my.clevelandclinic.org/health/treatments/13901-glp-1-agonists
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One Mnet Health solutions
To learn more about our pre-admission solution, please visit our Medical Passport webpage.
To learn more about our patient communication and engagement solution, please visit our Engage webpage.
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