Transition of medication information after bariatric surgery: The added value of a medication advice letter

Abstract

Background: Bariatric surgery is a popular and effective method for weight reduction. During the surgical procedure, alterations to the gastrointestinal tract are made which can lead to a different effect of oral drug substances. Medication information transmission plays a crucial role in adequate medication monitoring by a pharmacist. A pilot study (Utrecht, the Netherlands) has shown improvement after sending a medication advice letter. The aim of this study is to evaluate the experiences from pharmacists and general practitioners regarding the medication advice letter after bariatric surgery. Methods: For every bariatric surgery patient a medication advice letter was made during a period of two months. After discharge, the discharge prescriptions were checked and the letter was sent to the general practitioner and outdoor pharmacy. Two weeks later a questionnaire was sent to evaluate the satisfaction about the letter. Data from the pilot study were used to get insight in the result of the medication advice letter. The current medication overview was requested after six months and analyzed by looking for discrepancies. Results: Medication advice letters contained 6.51 (sd 2.81) advice per patient. Medication advice letters consisted of start advice (51.8%), monitor advice (29.3%), stop advice (9.0%) and other advice (9.9%). In total 30.8% of the advice was noticeably followed of which ‘start chronic’ was the largest group (34.9%). 16.3% of the advice was not followed where ‘start temporarily’ was by far the largest group (58.9%). 77% of the responders indicated that the medication advice letter was (very) useful. Only 26.9% said that the medication advice was feasible and 100% agreed that the lever of the letter was precisely right. Conclusions: Medication advice letters contained nearly seven advice per bariatric patient, of which 30% has been noticeably followed after six months. Pharmacists and general practitioners were delighted to receive the mediation advice letter.