Evidence map›Paper›PMID 33580318›Full record

ArticleSurgical endoscopy2022

Pharmacy-led initiative for improving peri-operative medication reconciliation among bariatric surgical patients: what is the role?

Elissa A Falconer, DeAngelo A Harris, Amanda Van Prooyen, Jessica Hicks, Arvinpal Singh, S Scott Davis, Edward Lin, Jyotirmay Sharma, Jonathan Pollock, Daniel V Samarov and 1 more

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
1.5field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 12 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Observational
  5. Article
  6. Article
  7. Article
  8. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 1 country.

Elissa A FalconerDivision of General and GI Surgery, Department of Surgery, Emory University School of Medicine, Room B206, 1364 Clifton Road NE, Atlanta, GA, 30322, USA. elissa.anne.falconer@emory.edu.ORCID 0000-0003-3095-0149
DeAngelo A HarrisDivision of General and GI Surgery, Department of Surgery, Emory University School of Medicine, Room B206, 1364 Clifton Road NE, Atlanta, GA, 30322, USA.
Amanda Van ProoyenClinical Pharmacy, Emory Healthcare, Atlanta, GA, USA.
Jessica HicksClinical Pharmacy, Emory Healthcare, Atlanta, GA, USA.
Arvinpal SinghDivision of General and GI Surgery, Department of Surgery, Emory University School of Medicine, Room B206, 1364 Clifton Road NE, Atlanta, GA, 30322, USA.
S Scott DavisDivision of General and GI Surgery, Department of Surgery, Emory University School of Medicine, Room B206, 1364 Clifton Road NE, Atlanta, GA, 30322, USA.
Edward LinDivision of General and GI Surgery, Department of Surgery, Emory University School of Medicine, Room B206, 1364 Clifton Road NE, Atlanta, GA, 30322, USA.
Jyotirmay SharmaDivision of General and GI Surgery, Department of Surgery, Emory University School of Medicine, Room B206, 1364 Clifton Road NE, Atlanta, GA, 30322, USA.
Jonathan PollockDivision of General and GI Surgery, Department of Surgery, Emory University School of Medicine, Room B206, 1364 Clifton Road NE, Atlanta, GA, 30322, USA.
Daniel V SamarovStatistical Engineering Division, Information Technology Laboratory, National Institute of Standards and Technology, Gaithersburg, MD, USA.
Elizabeth M HechenbleiknerDivision of General and GI Surgery, Department of Surgery, Emory University School of Medicine, Room B206, 1364 Clifton Road NE, Atlanta, GA, 30322, USA.
Emory University · USEmory Healthcare · USNational Institute of Standards and Technology · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMultiple medication changes are common after bariatric surgery, but pharmacist assistance in this setting is not well described. This study evaluated the feasibility and effectiveness of a pharmacy-led initiative for facilitating discharge medicine reconciliation after bariatric surgery.

methodsA standardized post-operative pharmacy consult evaluation was conducted on bariatric surgery inpatients at a single academic center starting 1/2/2019. Retrospective chart review evaluated patient characteristics, medication changes, and 30-day outcomes pre-intervention (7/2018-12/2018) and post-intervention (1/2019-12/2019). Two-sample t tests or binomial tests were used for continuous or categorical variables, respectively; a p-value of < 0.05 was deemed statistically significant.

resultsA total of 353 patients were identified for study inclusion (n = 158 pre-intervention, n = 195 post-intervention) with a mean age of 45 years, 87% female, and 71% sleeve gastrectomy. Overall pharmacy consultation compliance was 94% with 77.0% of home medication recommendations followed. Non-narcotic pain medication prescription use significantly increased (39% pre- vs. 54% post-intervention; p < 0.001). At discharge, the average number of changed or new medications significantly increased (3.7 ± 1.2 pre- vs. 4.2 ± 1.8 post-intervention; p = 0.003) while the average number of stopped medications was similar (1.2 ± 1.5 pre- vs. 1.5 ± 1.9 post-intervention; p = 0.09). Anti-hypertensive medications were decreased or stopped substantially more often with pharmacist input (44.7% pre- vs. 85.4% post-intervention; p < 0.001). Three medication-related readmissions happened pre-intervention with none post-intervention. Outpatient medication-related phone calls did considerably increase (31% pre- vs. 39% post-intervention; p = 0.04), while overall 30-day readmissions significantly decreased (7.6% pre- vs. 1.5% post-intervention; p = 0.04).

conclusionsInpatient pharmacy consultation facilitated rapid alteration to more appropriate therapy for hypertension management and significantly increased use of non-narcotic pain medications upon discharge among bariatric surgery patients. Improved protocol adherence is anticipated with program maturity and patient education interventions will be deployed to address outpatient phone calls.

Indexed as

Bariatric SurgeryPharmacyFemaleHumansMaleMedication ReconciliationMiddle AgedPatient DischargePharmacistsRetrospective StudiesBariatric surgeryMedication reconciliationPatient safetyPharmacy consultPharmacy-led initiative

Identifiers

PMID33580318
OpenAlexW3127510578

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.