Exploring the patient-reported impact of the pharmacist on pre-bariatric surgical assessment

Background: 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. Objective: To explore the patient-reported impact of the specialist bariatric pharmacist in pre-surgical assessment. Setting: National Health Service Hospital, United Kingdom. Methods: A 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. Results: A 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. Conclusions: The 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.