1. Implementation of Pharmacist Intervention, Care, and Advocacy with Bariatric Patients
Hannah Hemry, Connor Hunter, Bret Kinne, Sonya Thiessen
Advisor: Professor Vern Duba
Background
Obesity is on the rise in America. A common way to treat obesity is with a combination of diet, exercise, and surgery. The four most common surgeries in the US are the gastric sleeve, gastric bypass, lap band, and duodenal switch. (OECD, 2017; Rabkin, 2018)
Database Search Strategy
PubMed
(("bariatric surgery"[MeSH Terms] OR ("bariatric"[All Fields] AND "surgery"[All Fields]) OR "bariatric surgery"[All Fields]) AND ((("pharmacy"[MeSH Terms] OR "pharmacy"[All Fields] OR "pharmacies"[MeSH Terms] OR "pharmacies"[All Fields]) OR ("pharmacists"[MeSH Terms] OR "pharmacists"[All Fields] OR "pharmacist"[All Fields])) OR ("pharmaceutical services"[MeSH Terms] OR ("pharmaceutical"[All Fields] AND "services"[All Fields]) OR "pharmaceutical services"[All Fields]))) AND (("referral and consultation"[MeSH Terms] OR ("referral"[All Fields] AND "consultation"[All Fields]) OR "referral and consultation"[All Fields]) OR ("medication therapy management"[MeSH Terms] OR ("medication"[All Fields] AND "therapy"[All Fields] AND "management"[All Fields]) OR "medication therapy management"[All Fields]))
Embase
('bariatric surgery'/exp OR 'bariatric surgery') AND ('pharmacist'/exp OR 'pharmacist' OR 'pharmacy'/exp OR 'pharmacy') AND ('medication therapy management'/exp OR 'medication therapy management' OR 'consultation'/exp OR 'consultation' OR 'referral'/exp OR referral)
CINAHL Plus
(MH "Bariatric Surgery") AND (MH "Pharmacy Service" OR pharmacy OR pharmacist OR pharmacies OR pharmacists) AND (MH "Medication Management” OR (MH "Referral and Consultation")
Web of Science
(bariatric NEAR/1 Surgery) AND ((medication therapy management) OR (pharmacy NEAR/1 service) OR (referral OR consultation)) AND (pharmacy or pharmacies or pharmacist or pharmacists)
International Pharmaceutical Abstracts
(bariatric adj surger*).af. AND pharmacy practice.cc. AND pharmac*.af.
Scopus
( ALL ( {bariatric surgery} ) ) AND ( ALL ( {medication therapy management} ) ) AND ( ALL ( pharmacist OR pharmacists ) )
Cochrane Library
bariatric surgery AND medication therapy management AND pharmacy
TRIP Database
bariatric surgery AND pharmacy services AND medication therapy management
What Is A Scoping Review?
A scoping review provides preliminary assessment of potential size and scope of available research literature. It aims to identify the nature and extent of research evidence (usually including ongoing research). (Grant, 2009)
Results
Search yielded 342 citations. 55 citations remained after excluding electronic textbook chapters, blogs, on-going systematic reviews and clinical trials. 21 duplicates were removed leaving 34 citations. 19 were reviewed for this project.
Literature on therapeutic outcomes was found but articles specifically describing implementation of pharmaceutical intervention for bariatric patients is limited.
“Pharmaceutical Care and consult services for the bariatric surgery patient are not described in the literature.” (Silverman, et al., 2011)
“It is important that all health professional be made aware of the issues of drug disintegration, dissolution and adsorption from tablets and that pharmacists have greater participation in the decision-making processions governing drug administration.” (Guedes, et al., 2015)
“Specialty pharmacist consult services create in the minds of patients an understanding of pharmacists as clinical health care professionals and not just dispensers of medications.” (Schuh, 2015)
“Patient interviews showed that patients were expecting feedback and counseling from their pharmacist.” (Decottignies, et al., 2017)
Methods
Review of current literature using PubMed, Embase, CINAHL Plus, Scopus, Web of Science, International Pharmaceutical Abstracts, Scopus, Cochrane Library, and TRIP Database
Next Steps
Raise awareness of how pharmacists can intervene on behalf of bariatric patients
Survey pharmacists, bariatric centers of excellence, patients, and professional associations in an effort to reach a consensus on a pharmacist’s role in the bariatric patient’s well-being
Encourage publication and sharing of information regarding best practices for the implementation of bariatric pharmacist consultation services
Purpose
Our goal was to scope the evidence for specific references relating to the implementation of pharmacist intervention roles in bariatric surgery patient’s care.
Search Limitations
Limited to English language articles and abstracts. Literature that detailed pharmacist intervention in the text but not the abstract may be excluded.