Use of antiobesity medications in a bariatric surgery population: A collaborative approach with ambulatory care pharmacy services.

PURPOSE: Antiobesity medications (AOMs) are increasingly utilized in patients before and after bariatric surgery. However, patients experience challenges to initiating and continuing these medications, leading to high real-world rates of discontinuation. We describe collaboration between an ambulatory care pharmacy service and bariatric surgeons as an opportunity to enhance patient care and medication access, with the collaboration encompassing ambulatory care pharmacists, pharmacy technicians, surgeons, advanced practice providers, and clinic support staff. The strategies employed to design, implement, and optimize patient care to meet the increasing demand for support with AOMs are discussed.

SUMMARY: The workflow incorporated key activities from highly diverse existing ambulatory care pharmacy and bariatric surgery practices. Resources utilized included an electronic pharmacy referral, collaborative practice agreements, and facilitation of medication access, including through completion of prior authorizations. Enhancements focused on coordination of visits to stagger the timing of follow-up visits, providing support to patients through insurance and coverage challenges, and communication to allow the pharmacy team to focus on all medication-related challenges while triaging other concerns to the multidisciplinary team. A pilot program to assess feasibility was implemented with a single pharmacist in August 2022, and the workflow was expanded by the end of 2024 to include 4 ambulatory care pharmacists and 2 pharmacy technicians collaborating with every bariatric surgeon in a large academic health system.

CONCLUSION

The collaboration created a workflow to support an interdisciplinary standard of care for patients utilizing AOMs before and after bariatric surgery. This implementation approach can serve as a roadmap for other healthcare systems to support use of AOMs.