Impact of clinical pharmacist services on anticoagulation management of total joint arthroplasty: A retrospective observational study

Abstract

What is known and objective: Even if total joint arthroplasty (TJA) patients have received conventional antithrombotic therapy, the incidence of thrombosis remains high. Clinical pharmacists have been involved in the multidisciplinary team of orthopaedics, but their roles and functions are not yet defined. The objective of this study was to assess the impact of clinical pharmacist services on the use of anticoagulant drugs, the rationality of medication and the incidence of thrombosis in patients with TJA.Methods: This retrospective, observational cohort study was conducted for patients undergoing TJA procedures. Study variables were collected for a baseline period of 1

Interventions and impact of pharmacist-delivered services in perioperative setting on clinically important outcomes: a systematic review and meta-analysis

“…The majority of studies were conducted in the United States ( n = 9; 36%) 32 – 40 and China ( n = 9; 36%), 41 – 49 followed by the United Kingdom ( n = 3; 12%), 50 – 52 and one (4%) each in Australia, 53 Netherland, 54 Pakistan, 55 and Sudan 56 ( Table 1 ). Most of the studies ( n = 8; 32%) were carried out in orthopedic surgery, 35 , 37 , 38 , 41 , 44 , 47 , 49 , 52 followed by five (20%) studies each that included multiple units 43 , 53 – 56 and general surgery 39 , 42 , 46 , 50 , 51 ( Table 1 ). Three studies (12%) were conducted in bariatric surgical units, 33 , 34 , 40 and two (8%) each in cardiothoracic 36 ,…”

“…The majority of studies ( n = 20; 80%) used an uncontrolled study design, 12 (48%) retrospective, 32 – 34 , 37 , 39 , 41 , 42 , 45 , 46 , 49 , 51 , 52 5 (20%) prospective, 35 , 36 , 43 , 50 , 55 3 (12%) retro-prospective studies, 40 , 44 , 48 with a variety of observational methodological designs ( Table 1 ). The remaining five (20%) were controlled, all of which were randomized.…”

“…38 , 47 , 53 , 54 , 56 Follow-up duration among the included studies ranged from 9 days 52 to 36 months. 41 …”

“…The studies’ sample sizes ranged between 65 47 and 1227 patients 35 ( Table 1 ). Other than specifying one or more surgical units, the majority of studies ( n = 13; 52%) focused on a particular class of medication including antibiotics ( n = 5; 20%), 36 , 48 , 49 , 55 , 56 analgesics ( n = 3, two of which on opioids), 37 , 38 , 44 and one each on anticoagulants, 41 antidiabetic drugs, 39 antiemetics, 43 proton pump inhibitor, 46 and total parenteral nutrition (TPN) 42 ( Table 2 ). Among the reminder studies, two focused on patients with mild systemic disease 50 , 51 and two on patients at higher risk for medication misadventures.…”

Implementing an innovative, patient-centered approach to day case arthroplasty: improving patient outcomes through remote preoperative pharmacist consultations

“…VTE is a major clinical and economic burden to the global healthcare system, and patients undergoing joint arthroplasty surgery are at high risk of VTE postoperatively. 19 The estimated cost for just one NHS Scotland health board for hospital admissions owing to VTE in 2011-2017 was greater than £23 million, in addition to more than 3000 deaths caused by VTE being recorded from 2008-2017. 20 The project demonstrated via retrospective review of prescriptions generated before the…”