Identification of Medication-Related Risks in Bariatric Surgery Patients by Performing Structured Medication Reviews

Obes Surg. 2023 Dec;33(12):3932-3937. doi: 10.1007/s11695-023-06889-5. Epub 2023 Oct 26.

Abstract

Purpose: More medication-related issues are seen with the growing demand for bariatric surgery, because of possible altered pharmacokinetics after surgery. Collaboration with a pharmacist could improve the short- and long-term safety and efficacy of pharmacotherapy in patients undergoing bariatric surgery. The aim of this study was to evaluate the impact of a structured medication review to identify medication-related risks before bariatric surgery.

Materials and methods: The impact on pharmacy-led interventions of introducing a structured medication review was evaluated in a historically controlled study. In the retrospective part, we evaluated patient characteristics, medication use, and number of pre-surgery consultations with a pharmacist before the introduction of medication reviews. A flowchart was developed to detect the use of medicines with risks associated with bariatric surgery. In the prospective part, we evaluated pharmacy-led interventions after the introduction of structured medication reviews using the flowchart. Outcome effectiveness was measured through the number of pre-surgery pharmacy-led interventions.

Results: Before using the flowchart for screening on risk medicines, 40 (2.6%) pharmacy-led interventions were identified in 1536 patients. In the prospective group, 195 patients were included and 88 (45%) interventions were identified (p < 0.001).

Conclusion: A structured medication review before bariatric surgery significantly increased the number of pharmacy-led interventions in bariatric surgery patients. This procedure will shift interventions to pre-surgery instead of post-surgery, contributing to the optimization of pharmacotherapy at an early stage.

Keywords: Bariatric surgery; Medication-related risks; Pharmacotherapy; Pharmacy-led interventions; Structured medication reviews.

MeSH terms

  • Bariatric Surgery*
  • Humans
  • Medication Review
  • Obesity, Morbid* / surgery
  • Pharmaceutical Services*
  • Retrospective Studies