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

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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.

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Acknowledgements

The authors would like to thank the contribution of the secretaries of the obesity center, the data managers of the obesity center, Dr. S.W. Nienhuijs of the obesity center and Dr. S.J.M. Kolfschoten, M.M.P.M van Rijzingen–van der Donk.

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Authors and Affiliations

  1. Department of Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands

    Doortje T.M.M. Böhm

  2. Obesity Center, Catharina Ziekenhuis, Eindhoven, The Netherlands

    Kim Berghuis & Mohammed Said

  3. Department of Clinical Pharmacy, Catharina Ziekenhuis, Michelangelolaan 2, 5623, EJ, Eindhoven, The Netherlands

    Marieke C.H.M. Kerskes, Maarten J. Deenen & Diane E.T. Bastiaans

  4. Department of Clinical Pharmacy and Toxicology, Leiden University Medical Centre, Leiden, The Netherlands

    Maarten J. Deenen

Authors
  1. Doortje T.M.M. Böhm
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  2. Kim Berghuis
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  3. Mohammed Said
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  4. Marieke C.H.M. Kerskes
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  5. Maarten J. Deenen
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  6. Diane E.T. Bastiaans
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Corresponding author

Correspondence to Diane E.T. Bastiaans.

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The authors declare no competing interests.

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Key Points

• Bariatric surgery can alter pharmacokinetics.

• Influence of surgery on safety and efficacy of pharmacotherapy should be considered.

• Structured medication reviews can identify medication-related risks before surgery.

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Böhm, D.T., Berghuis, K., Said, M. et al. Identification of Medication-Related Risks in Bariatric Surgery Patients by Performing Structured Medication Reviews. OBES SURG 33, 3932–3937 (2023). https://doi.org/10.1007/s11695-023-06889-5

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  • DOI: https://doi.org/10.1007/s11695-023-06889-5

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