Improving the medicines management aspects of the discharge process for bariatric patients...Royal Pharmaceutical Society Annual Conference, November 7, 2025, London, United Kingdom

Purcell,A.; Goor,O.; Coe,P.

Improving the medicines management aspects of the discharge process for bariatric patients...Royal Pharmaceutical Society Annual Conference, November 7, 2025, London, United Kingdom

All Authors

Purcell,A.

Goor,O.

Coe,P.

LTHT Author

Purcell, Andrew
Goor, Olivia Goor
Coe, Peter

LTHT Department

Medicines Management & Pharmacy Services
Clinical Pharmacy
Abdominal Medicine & Surgery
Drs Rotation

Non Medic

Advanced Clinical Pharmacist
Pharmacy Technician

Publication Date

2025

Item Type

Conference Abstract

Abstract

Introduction: The importance of medication optimisation in patients undergoing bariatric surgery is well documented and the significance of pharmacy team involvement noted 1,2]. Conversion to liquid or crushed preparations for patients after bariatric surgery is a requirement for at least 6 weeks at Leeds Teaching Hospitals (LTHT) 3]. Feedback highlighted inefficiencies in the discharge process, in particular time spent waiting for medications to be dispensed, which impacted quality of care and resulted in significant discharge delays. Aim: To reduce length of stay for patients by having medications prepared earlier on during inpatient stay Utilise pharmacy technicians as a resource to aid prescribing and selection of appropriate formulations for patients undergoing bariatric surgery To standardise discharge medications in line with an agreed discharge protocol Methodology: Patients were followed remotely to outline a 憈ypical� bariatric surgery patient journey from admission through to discharge. A baseline cohort of 35 patients, who underwent bariatric surgery at LTHT between July - December 2023, were identified. Digital time stamps were retrospectively reviewed to evaluate and the timing of key medication related processes (e.g. electronic discharge advice note (eDAN) writing, pharmacist validation, dispensing and delivery of medication to the ward, pharmacy interventions). The process was re-designed to allow completion of drug history in advance of admission and to initiate the eDAN process earlier in the patient journey (before, rather than after, surgery). A retrospective analysis of eDAN completion time was performed, investigating the frequency eDANs completed and dispensed prior to day-one post-op ward round. A standard discharge protocol for discharge medications was also introduced and embedded with prescribing software to improve the quality of prescribing. A retrospective review of medications on eDANs was undertaken to review compliance with this protocol. Non-compliance was investigated and reviewed for appropriateness. A pharmacy technician received education and training on how to advise regarding medication formulation switches and when to refer to the pharmacist. Results: The re-design of the bariatric inpatient process to run the medication and surgery workstreams concurrently, rather than consecutively, has eliminated waiting time for discharge medication. Reducing potential length of stay by 6.5h per patient The intervention has so far been implemented in 50 patients. And has therefore reduced medication-associated delays by 448.5h between July 2024-January 2025 The prescribing of 8 discharge medication requirements was measured as indicators of quality (adherence with guidelines), 97%-100% met the standard in 87 of the indicators. Where the standard was not met justifications were appropriate. Discussion: Implementation of a discharge protocol and preadmission review of medications by pharmacy improved quality of prescribing for patients undergoing bariatric surgery at LTHT. Changing the eDAN process to be undertaken whilst the patient is in theatre removed the need for patients to wait for their discharge medications facilitating faster discharge and reducing inpatient length of stay.