Bariatric Surgery Pharmacy Consultation Service

Abstract

Bariatric surgical patients often need changes in formulation and dosages of their medications. The literature contains minimal information regarding pharmaceutical care and consultation services for the bariatric surgery patient. Complex medication regimens and safety concerns initiated a collaborative effort between surgeons and pharmacists to manage more effectively bariatric patients perioperatively. The consultation service included patient identification, pharmacy referral, pharmacist consultation with the patient, communication of recommendations with surgeons, follow-up, and documentation. There were 124 consultations performed from February 2, 2009 to December 1, 2010 with an average of 7.7 medications optimized per patient. Every patient required a minimum of one adjustment to their regimen. The surgeons approved 98% of these recommendations. Of recommendations provided, the majority focused on changing the formulation of the medication in some manner. The collaborative effort between surgeons and pharmacists effected changes in medication transitioning perioperatively and resulted in improved pharmaceutical care for this patient population.

Practical Recommendations of the Obesity Management Task Force of the European Association for the Study of Obesity for the Post-Bariatric Surgery Medical Management

“…When discharged from the hospital, patients should be carefully instructed on the modifications of their medication regimen, including changes in prescription drugs, over-the-counter drugs, nutrient supplements and homeopathic drugs. Involvement of pharmacists as advisors in the drug treatment is beneficial for both surgeons and patients [80]. If possible, oral liquid-dosage forms should be used instead of solid-dosage forms for at least 2 months after surgery.…”

Hypertension and diabetes mellitus medication management in sleeve gastrectomy patients

“…12,13 Pharmacists have a unique opportunity to increase patient safety in bariatric surgery in the immediate postoperative period. Pharmacists can assist surgeons by performing medication reconciliation and patient interviews.…”

Malnutrition secondary to non-compliance with vitamin and mineral supplements after gastric bypass surgery: What can we do about it?

“…Silverman et al [30] performed 124 consultation services for bariatric surgery patients from February 2, 2009 to December 1, 2010. Their services included patient identification, pharmacy referral, pharmacist consultation with the patient, communication of recommendations with surgeons, follow-up and documentation.…”

“…Their services included patient identification, pharmacy referral, pharmacist consultation with the patient, communication of recommendations with surgeons, follow-up and documentation. They concluded that the collaborative effort between surgeons and pharmacists effected changes in medication transitioning perioperatively and resulted in improved pharmaceutical care for this patient population [30]. Such services might improve patient compliance with medications; however the literature contains minimal information regarding pharmaceutical care and consultation services for the bariatric surgery patient and to our knowledge their effect on compliance rates has not been adequately addressed.…”