Implications of Bariatric Surgery on Absorption of Nutrients and Medications

Mary Carpenter, PharmD; Mary Ellen Pisano, PharmD; Christopher M. Bland, PharmD, BCPS, FIDSA

Disclosures

US Pharmacist. 2016;41(12):HS-2-HS-8. 

In This Article

Clinical Considerations

Pharmacists have the opportunity to change clinical outcomes and improve quality of life for bariatric patients through knowledge of available dosage forms and treatment alternatives, as well as principles of compounding. Pharmacists also can assess tolerability of dosage forms to evaluate a need for change to increase medication adherence. A retrospective pilot study described vitamin/nutrient supplement practices and assessed medication dosage formulations utilized in patients hospitalized with a history of bariatric surgery.[27] Of the 133 admissions, at least one discrepancy was found in 117 of them. A multivitamin was ordered in only 33% of admissions and a calcium supplement in 7.7%. Inappropriate medication formulations were ordered in 61.5% of patients (34.7% non–immediaterelease formulations, 25% enteric-coated formulations, and 40.3% both formulations). Fifty percent had inappropriate formulations continued upon discharge.[27] Pharmacists can, therefore, have a significant role in medication reconciliation and discharge counseling to ensure appropriate drug prescribing.

From the findings of the above study, it is evident that pharmacists can play a role in improving patient care in community, ambulatory, and hospital settings by serving as a resource to healthcare providers, especially regarding recommended vitamin intake and dosage-form selection. Evidence of the positive impact of a multidisciplinary care team including a pharmacist has been demonstrated. A retrospective study evaluating hypertension and diabetes medication adjustments in post-LSG patients demonstrated the value of a multidisciplinary approach that included an endocrinologist and clinical pharmacist.[28] Another study demonstrated the use of pharmacy consultation services for dosageform adjustments in the perioperative management of bariatric patients.[29]

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