# Drug dissolution problems in ostomy patients: a chart review and patient interview analysis

## TL;DR

This study found that many medications do not dissolve properly in ostomy patients, causing issues with drug effectiveness and the need for better patient education.

## Contribution

The study identifies drug dissolution problems in ostomy patients through chart reviews and patient interviews, highlighting the need for improved education.

## Key findings

- 22.4% of prescribed drug formulations were critical for pharmacokinetic release in ostomy patients.
- 22% of interviewed patients reported undissolved drugs in their stoma bags.
- Over 60% of patients lacked information about undissolved drug formulations in their stoma bags.

## Abstract

The pharmacokinetic properties of peroral drugs, e.g. considering dissolution, release and absorption, can be influenced by a shortened transit time after ostomy placement. Its aim was to find unexpected undissolved drugs in stoma bags and establish a correlation with formulations using patient interviews and chart review analysis.

(i) A patient chart review was performed to assess prescribed drugs on the basis of their formulation and potential influence on pharmacokinetics. (ii) Subsequent to the chart review, the patient was interviewed to ascertain (ii.a) the appearance of indigested drugs in the stoma bag, (ii.b) observed changes in drug efficacy and therapy, and (ii.c) information status regarding indigestible and undissolved formulations.

(i) 22.4% (134/598) of the prescribed formulations were assessed as critical concerning their pharmacokinetic release characteristics. (ii.a) A total of 22.0% (11/50) of the interviewed patients indicated that they had experienced this at least once. (ii.b) Of the patients, 14.0% (7/50) observed changes in drug efficacy, and 12% (6/50) experienced changes in their therapy regimens. (ii.c) More than 60% of the patients lacked information that indigestible and undissolved formulations could be found in their stoma bag.

A considerable proportion of formulations investigated caused problems for patients with ostomy. Additional patient education and resources are needed to support ostomy patients by managing drug release-related problems.

The online version contains supplementary material available at 10.1007/s00384-025-04907-9.