Medication management and clinical pharmacy services in adults with ileostomy or colostomy: a scoping review

Background Patients with ileostomy or colostomy may be vulnerable to medication-related issues because of changes in gastrointestinal anatomy and physiology. However, the evidence on medication management and clinical pharmacy care in this population has not been systematically mapped. Aim This scoping review aimed to map the evidence on medication management and clinical pharmacy services in patients with an ileostomy or colostomy. Method A scoping review was conducted according to Joanna Briggs Institute methodology and reported in accordance with PRISMA-ScR. PubMed, Embase, CINAHL, Scopus, LIVIVO, and Open Dissertations were searched from inception to June 8, 2026. Titles, abstracts, and full texts were screened independently by two researchers, followed by data extraction and synthesis. Results Eight publications from Germany, Austria, and Brazil met the inclusion criteria. High medication burden and polypharmacy were frequently reported. Medication-related issues included undigested dosage forms, perceived changes in medication effectiveness, and ostomy-specific drug-related problems. Several medication risk-assessment and review approaches were described, including dosage-form classifications, time-to-maximum-concentration criteria, and a structured decision-tree tool. Pharmacist-led interventions included medication review, dosage-form optimisation, therapeutic monitoring, treatment recommendations, and patient counselling. Implementation or acceptance of pharmaceutical recommendations was generally high where reported. However, patient-relevant clinical and economic outcomes were not systematically evaluated. Conclusions The included publications describe medication-related problems and approaches to medication management in patients with an ileostomy or colostomy. Structured medication review and pharmacist involvement may help address these challenges, but evidence of their effects on patient-relevant outcomes remains insufficient. Further prospective studies are needed to evaluate clinical effectiveness.