Abstract
BackgroundThe effects of surgical procedures and the need for life-long nutrient supplementation may impact on medication regimes, requiring changes to dosage and formulation of medicines, which can be difficult for patients following surgery. Our pre-surgical assessment pathway involves a pharmacist with specialist knowledge of bariatric surgery, to help prepare patients for these changes.ObjectiveTo explore the patient-reported impact of the specialist bariatric pharmacist in pre-surgical assessment.SettingNational Health Service Hospital, United Kingdom.MethodsA two phased, retrospective study design using participants recruited from pre-surgical clinic lists. The first phase consisted of confidential, face to face semi-structured interviews. A constant comparative analytic framework informed the construction of the second phase, which consisted of a confidential survey to test the generalizability of the findings with a larger cohort of patients.ResultsA total of 40 participants (12 interviews, 28 surveys) were recruited to the study. The majority of participants were female (n = 33), mean age 50 years, mean pre-surgical weight 124 kg (n = 38). The most common comorbidity was type 2 diabetes. Participants on medication had at least one comorbidity, with the majority of conditions improved or eliminated after surgery.ConclusionsThe pre-surgical consultation with the pharmacist was highly valued by the participants, providing information and support which helped prepare for medication changes after bariatric surgery. Many felt that a post-surgical appointment with the pharmacist would provide support and improve compliance with vitamins and medications. Future research into the role of pharmacists in the bariatric multi-disciplinary team and patient support are recommended.
Highlights
Many people with obesity who seek bariatric surgery have related comorbidities, necessitating polypharmacy
There is a need for lifelong follow-up and nutritional supplementation
Bariatric surgery is time of immense physical, social and personal change [5, 6] which requires a period of adjustment for patients
Summary
Many people with obesity who seek bariatric surgery have related comorbidities, necessitating polypharmacy. The malabsorptive and restrictive effects of bariatric surgical procedures and resultant rapid weight loss necessitate life-long vitamin and mineral supplementation surgery [2]. This often means altered pharmacokinetics of medications, e.g. dose, formulation and timing [3, 4] which vary according to the individual health status of patients. Bariatric surgery is time of immense physical, social and personal change [5, 6] which requires a period of adjustment for patients. The effects of surgical procedures and the need for life-long nutrient supplementation may impact on medication regimes, requiring changes to dosage and formulation of medicines, which can be difficult for patients following surgery. Our pre-surgical assessment pathway involves a pharmacist with specialist knowledge of bariatric surgery, to help prepare patients for these changes
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