Improved postoperative blood glucose control through implementation of clinical pharmacist driven glycemic management model after colorectal surgery

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.…”

“…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.…”

“…Fourteen studies (56%) reported that patients were the target of the implemented pharmacist-delivered services, 33 – 35 , 38 – 40 , 44 , 45 , 47 , 50 – 54 while seven studies (28%) reported that patients alongside medical staff were the recipient of the intervention. 32 , 36 , 41 , 43 , 46 , 48 , 49 Four studies (16%) reported that the pharmacist intervention was intended for medical staff, mainly surgeons with or without other healthcare providers such as nurses or anesthesiologists.…”

“…All studies, except for one, 39 reported the settings where the intervention took place. The intervention was delivered at hospital bedside in nine studies (36%), 33 , 35 , 40 , 41 , 43 – 45 , 47 , 54 while another nine (36%) reported other settings alongside the hospital bedside such as hospital clinic, 32 recipient’s home, 51 , 53 hospital in general (refers to interventions that included educational session), 37 , 46 , 48 or a combination of them.…”