CONSULTATION SESSIONS WITH BARIATRIC SURGERY PATIENTS: A PHARMACIST INTERVENTION AT ZUYDERLAND HOSPITAL
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European Statement
Clinical Pharmacy Services
Author(s)
Vera Hoebregts, Evert-Jan Boerma, Mark Reinders
Why was it done?
The initiative was introduced to address the complex medication needs of bariatric surgery patients, particularly those using risk medication. More and more research is available about the effect of bariatric surgery on medication. Before this initiative, there was a gap in personalized medication management for this patient population. The aim was to optimize medication regimens, enhance patient safety and create awareness about the influence of bariatric surgery on specific medication among bariatric patients.
What was done?
In response to the growing need for personalized care among bariatric surgery patients, Zuyderland Medical Center and the Dutch Obesity Clinic South initiated consultation sessions with a pharmacist for patients scheduled for bariatric surgery using risk medication. A scoring list was developed to identify patients eligible for these consultations. Additionally, a survey was conducted to assess patient perceptions of the consultation’s usefulness.
How was it done?
Our developed risk medication screening list for bariatric patients was used to identify patients eligible for pharmacist consultations. Notable medications on the list included lithium, oral antipsychotics, antiepileptics, direct oral anticoagulants, levothyroxine, and tamoxifen. Approximately 10% of bariatric patients met the consultation criteria. Eligible patients were informed by their surgeon during pre-operative consultations and subsequently scheduled a session with the pharmacist. These consultations centered on discussing the patient’s specific risk medications and how bariatric surgery might impact their efficacy or toxicity. If relevant, issues such as medication-related weight gain, ingestion challenges, and compliance were addressed. Pharmacists’ recommendations were shared with the patient’s physician or other relevant healthcare professionals (e.g. a neurologist regarding a patient with epilepsy).
What has been achieved?
Increased awareness about the effect of bariatric surgery on medication is created both among staff and patients. Patients reported high satisfaction levels (average score of 9,3 out of 10 (n=20)) with the consultations, mentioning enhanced understanding of their medication regimens. Furthermore, an increased confidence in managing their health postoperatively was precepted. Patients found this consultation of added value.
What next?
This initiative serves as an exemplary model of personalized care delivery in bariatric surgery settings. Its success underscores the value of pharmacist involvement in optimizing medication therapy for complex patient populations.