Management of Chronic Medication Therapies in the Perioperative Period: a Literature Review

Almeida, de; Pereira, Cristina; Couto, Paula; Machado, Humberto S

doi:10.4172/2155-6148.1000760

Cited by 2 publications

(1 citation statement)

References 18 publications

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“…5 However, majority of the patients scheduled for elective surgery are on chronic medications, which make their management an essential priority for every healthcare member participating in the perioperative period. 6 According to Lee et al, 7 medication discrepancies are more frequent for surgical patients as compared to medical patients, particularly in adjusting chronic medications postoperatively, which raise patient safety concerns for these patients despite perioperative practice guidelines recommending continuation or rapid re-initiation of these medications.…”

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confidence: 99%

Drug-related problems and determinants among elective surgical patients: A prospective observational study

2022

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Objectives: The aim of this study was to assess drug-related problems and determinants among elective surgical patients admitted to Jimma University Medical Center. Methods: A hospital-based prospective observational study was conducted at Jimma University Medical Center, from April 10 to July 10, 2018. Data were collected through patients’ interview and physicians’ medication orders and charts review using pre-tested questionnaire and data abstraction formats. Drug-related problems were assessed for each patient using drug-related problem classification tool. Data were analyzed using Statistical Package for Social Science for windows; version 21.0. The predictors of drug-related problems were determined by multivariable logistic regression analysis. A p-value of less than or equal to 0.05 was considered to be statistically significant. Results: Of the total 141 participants, 98 (69.5%) of them had at least one drug-related problem during their hospital stay. A total of 152 drug-related problems were identified among 141 elective surgical patients. The most common identified drug-related problems were indication-related problems (39%) followed by effectiveness-related problems (21%) and safety-related problems (21%). The presence of complication (adjusted odds ratio = 2.90, 95% confidence interval (1.302, 3.460)), American Society of Anesthesiologists Physical Status ⩾ 2 (adjusted odds ratio = 6.01, 95% confidence interval (1.0011, 9.500)), and postoperative antibiotics (adjusted odds ratio = 6.027, 95% confidence interval (1.594, 22.792)) were independent predictors of drug-related problems. Conclusion: The prevalence of drug-related problems is high among elective surgical patients. The indication-related problems were the most common category of drug-related problem identified among elective surgical patients. The presence of complication, American Society of Anesthesiologists Physical Status ⩾ 2, and postoperative antibiotics were the independent predictors of drug-related problems.

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Section: Introductionmentioning

confidence: 99%

Drug-related problems and determinants among elective surgical patients: A prospective observational study

2022

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Development of an innovative clinical pharmacy service in a urology surgical unit: a new initiative from Qatar

Naseralallah,

Koraysh,

Isleem

et al. 2024

Journal of Pharmaceutical Policy and Practice

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Purpose To provide an insight into the role of a clinical pharmacy initiative in a surgical urology unit through evaluating the nature, significance, associated medications, and acceptance rate of pharmacist interventions. Methods A cross-sectional study was carried out at the Ambulatory Care Center (ACC), Doha, Qatar. Data related to clinical pharmacist interventions and associated rationale were classified according to the nature of the intervention using an adapted classification system. The assessment of the severity followed the National Patient Safety Agency (NPSA) Risk Matrix. Linear regression, Kruskal–Wallis, and post-hoc analyses were performed to determine the association between patient-related and medication-related characteristics on pharmacist interventions. Results A total of 3284 interventions (on 1486 patients) were analysed. Most patients ( n = 1105; 74.4%) had 1–2 interventions. Age and gender showed a positive linear correlation with the number of interventions per patient ( p < 0.01). Majority of interventions were related to pharmacological strategy ( n = 1858; 56.6%) and quantity of drug ( n = 821; 25%). Additional drug therapy ( n = 748; 22.78%) was the most common subcategory followed by optimum dose/frequency ( n = 691; 21.04%) and discontinuation of medications ( n = 352, 10.72%). Anti-infectives were the most identified drug category ( n = 798, 55.1%). Most interventions (59.4%) were of moderate significance; patients with moderate interventions were found to be older compared to patients with minor interventions ( p = 0.032). Prescribers’ acceptance rate was high (>90%), with a notable increase of 6.6% from 2021 to 2023. Conclusion This study showed that the clinical pharmacy service in the urology surgical field was a fruitful initiative. The clinical pharmacist's role has expanded to include not only therapeutic optimisation while ensuring medication safety across the continuum of perioperative care but also the identification and management of untreated health problems. The dynamic and complexity of the urology patient population challenge clinical pharmacists; however, the practice concepts remain the same as in any other clinical setting.

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Management of Chronic Medication Therapies in the Perioperative Period: a Literature Review

Cited by 2 publications

References 18 publications

Drug-related problems and determinants among elective surgical patients: A prospective observational study

Drug-related problems and determinants among elective surgical patients: A prospective observational study

Development of an innovative clinical pharmacy service in a urology surgical unit: a new initiative from Qatar

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