Pharmacy-led initiative for improving peri-operative medication reconciliation among bariatric surgical patients: what is the role?

Falconer, Elissa A.; Harris, DeAngelo A.; Prooyen, Amanda Van; Hicks, Jessica L.; Singh, Arvinpal; Davis, Scott; Lee, Edward; Sharma, Jyotirmay; Pollock, Julius; Samarov, Daniel V.; Hechenbleikner, Elizabeth M.

doi:10.1007/s00464-021-08343-y

Cited by 6 publications

(16 citation statements)

References 23 publications

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“…The majority of studies were conducted in the United States ( n = 9; 36%) 32 – 40 and China ( n = 9; 36%), 41 – 49 followed by the United Kingdom ( n = 3; 12%), 50 – 52 and one (4%) each in Australia, 53 Netherland, 54 Pakistan, 55 and Sudan 56 ( Table 1 ). Most of the studies ( n = 8; 32%) were carried out in orthopedic surgery, 35 , 37 , 38 , 41 , 44 , 47 , 49 , 52 followed by five (20%) studies each that included multiple units 43 , 53 – 56 and general surgery 39 , 42 , 46 , 50 , 51 ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Most of the studies ( n = 8; 32%) were carried out in orthopedic surgery, 35 , 37 , 38 , 41 , 44 , 47 , 49 , 52 followed by five (20%) studies each that included multiple units 43 , 53 – 56 and general surgery 39 , 42 , 46 , 50 , 51 ( Table 1 ). Three studies (12%) were conducted in bariatric surgical units, 33 , 34 , 40 and two (8%) each in cardiothoracic 36 , 48 and transplant units. 32 , 45 The majority of studies were published in 2019 onward, except for one each in 2015, 54 2016, 48 and 2018.…”

Section: Resultsmentioning

confidence: 99%

“…The majority of studies ( n = 20; 80%) used an uncontrolled study design, 12 (48%) retrospective, 32 – 34 , 37 , 39 , 41 , 42 , 45 , 46 , 49 , 51 , 52 5 (20%) prospective, 35 , 36 , 43 , 50 , 55 3 (12%) retro-prospective studies, 40 , 44 , 48 with a variety of observational methodological designs ( Table 1 ). The remaining five (20%) were controlled, all of which were randomized.…”

Section: Resultsmentioning

confidence: 99%

“…Fourteen studies (56%) reported that patients were the target of the implemented pharmacist-delivered services, 33 – 35 , 38 – 40 , 44 , 45 , 47 , 50 – 54 while seven studies (28%) reported that patients alongside medical staff were the recipient of the intervention. 32 , 36 , 41 , 43 , 46 , 48 , 49 Four studies (16%) reported that the pharmacist intervention was intended for medical staff, mainly surgeons with or without other healthcare providers such as nurses or anesthesiologists.…”

Section: Resultsmentioning

confidence: 99%

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Interventions and impact of pharmacist-delivered services in perioperative setting on clinically important outcomes: a systematic review and meta-analysis

Naseralallah,

Koraysh,

Aboujabal

et al. 2024

Therapeutic Advances in Drug Safety

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Background: The perioperative arena is a unique and challenging environment that requires coordination of the complex processes and involvement of the entire care team. Pharmacists’ scope of practice has been evolving to be patient-centered and to expand to variety of settings including perioperative settings. Objectives: To critically appraise, synthesize, and present the available evidence of the characteristics and impact of pharmacist-led interventions on clinically important outcomes in the perioperative settings. Design: A systematic review and meta-analysis. Methods: We searched PubMed, Embase, and CINAHL from index inception to September 2023. Included studies compared the effectiveness of pharmacist-led interventions on clinically important outcomes (e.g. length of stay, readmission) compared to usual care in perioperative settings. Two independent reviewers extracted the data using the DEPICT-2 (Descriptive Elements of Pharmacist Intervention Characterization Tool) and undertook quality assessment using the Crowe Critical Appraisal (CCAT). A random-effect model was used to estimate the overall effect [odds ratio (OR) for dichotomous and standard mean difference (SMD) for continuous data] with 95% confidence intervals (CIs). Results: Twenty-five studies were eligible, 20 (80%) had uncontrolled study design. Most interventions were multicomponent and continuous over the perioperative period. The intervention components included clinical pharmacy services (e.g. medication management/optimization, medication reconciliation, discharge counseling) and education of healthcare professionals. While some studies provided a minor description in regards to the intervention development and processes, only one study reported a theoretical underpinning to intervention development. Pooled analyses showed a significant impact of pharmacist care compared to usual care on length of stay (11 studies; SMD −0.09; 95% CI −0.49 to −0.15) and all-cause readmissions (8 studies; OR 0.60; 95% CI 0.39–0.91). The majority of included studies ( n = 21; 84%) were of moderate quality. Conclusion: Pharmacist-led interventions are effective at improving clinically important outcomes in the perioperative setting; however, most studies were of moderate quality. Studies lacked the utilization of theory to develop interventions; therefore, it is not clear whether theory-derived interventions are more effective than those without a theoretical element. Future research should prioritize the development and evaluation of multifaceted theory-informed pharmacist interventions that target the whole surgical care pathway.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Interventions and impact of pharmacist-delivered services in perioperative setting on clinically important outcomes: a systematic review and meta-analysis

Naseralallah,

Koraysh,

Aboujabal

et al. 2024

Therapeutic Advances in Drug Safety

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“…Collaborations between pharmacists and surgeons can improve perioperative bariatric surgery patients' pharmaceuticals. Additionally, due to the possible changes in drug absorption and the expected need for drug adjustment, pharmacists' involvement in the drug management and drug reconciliation upon discharge can ensure a safe and effective transition for bariatric surgery patients 14–16 …”

Section: Drug Absorption After Bariatric Surgerymentioning

confidence: 99%

Drug absorption in bariatric surgery patients: A narrative review

Alalwan

Friedman

Alfayez

et al. 2022

Health Science Reports

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Background: Despite the increase in the number of bariatric surgeries performed, little is known about the impact of the surgery on drug absorption. Unpredictability is assumed with drugs, given the anatomical changes after surgery.Objective: To evaluate the impact of bariatric surgery on drug absorption based on the type of procedure performed. Methods:We conducted a comprehensive literature review searching PubMed/ Medline for published studies (from inception to December 2017) that evaluate the use of drugs and the assessment of drug absorption after bariatric surgery.Pharmacokinetic/pharmacodynamic studies, case reports, and observational studies were included in our review. Results:We found 60 studies addressing drug use after bariatric surgery. Twentyeight studies reported a decrease in drug absorption after bariatric surgery while only four studies showed an increase in drug absorption. Unchanged absorption of drugs was seen in 23 studies after the surgery. Conclusion:The available information shows variations in drug absorption after bariatric surgery. The unpredictability may result from factors related to the patient, drug, and/or type of surgery. Therefore, pharmacists' involvement and close monitoring of patients after bariatric surgery could be effective to avoid sub-/ supratherapeutic responses.

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Opioid prescribing practices following bariatric surgery: a systematic review and pooled proportion meta-analysis

et al. 2022

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Pharmacy-led initiative for improving peri-operative medication reconciliation among bariatric surgical patients: what is the role?

Cited by 6 publications

References 23 publications

Interventions and impact of pharmacist-delivered services in perioperative setting on clinically important outcomes: a systematic review and meta-analysis

Interventions and impact of pharmacist-delivered services in perioperative setting on clinically important outcomes: a systematic review and meta-analysis

Drug absorption in bariatric surgery patients: A narrative review

Opioid prescribing practices following bariatric surgery: a systematic review and pooled proportion meta-analysis

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