Post-bariatric surgery adherence to clinical pharmacist recommendations in the ambulatory-care setting: A 6-month post-surgery analysis

Background: Clinical pharmacist consultations play a vital role in optimizing medication management for bariatric patients. However, postdischarge implementation remains largely unknown. Objectives: The aim of this work was to characterize the different types of recommendations made by clinical pharmacists in bariatric patients, and to assess adherence to these recommendations in the ambulatory-care setting. Methods: A retrospective analysis was conducted at Herzliya Medical Center, where patients were operated, and Clalit Health Services, the largest Health Maintenance Organization (HMO) in Israel. A total of 210 bariatric patients received clinical pharmacist consultation and a letter to the community clinics between 2013 and 2019. In phase one, we analyzed the types and frequency of recommendations provided. In phase two, adherence in the community was evaluated using HMO medical records over 6 months postdischarge. Results: In the first analysis of 210 patients, there was a mean of 9 recommendations per patient. The most common were drug discontinuation (40.9%) and new medication addition (14.8%). Recommendations often addressed chronic conditions, mainly diabetes (36.9%) and hypertension (31.8%). In total, 153 Clalit HMO patients were analyzed for adherence. The overall adherence rate was 77.7%. No significant correlations were found with age, comorbidities, or preoperative medication count to adherence rate. A significant negative correlation was observed between adherence and the number of recommendations (P = 0.007). Conclusion: The high adherence rate to hospital clinical pharmacist's recommendations highlights the value of specialized clinical pharmacist consultation in bariatric care. These consultations may improve implementation of treatment plans among both patients and health care providers.