Perioperative clinical pharmacy practice: Responsibilities and scope within the surgical care continuum

Abstract

Current published guidelines for perioperative pharmacy services have limited information on the development and implementation of a robust clinical pharmacy program across the surgical continuum of care. This publication defines the responsibilities and scope of practice of the Perioperative Clinical Pharmacist (PCPh), supporting the PCPh as a critical member of the interprofessional surgical patient care team. Opportunities for pharmacist role integration into perioperative medication management processes are described along with published examples of successful PCPh practice models, including those with interventions targeted toward Enhanced Recovery Pathways (ERP). Recommended training and competencies for future and practicing perioperative pharmacists, in addition to considerations for precepting and scholarly activities, are also outlined. Finally, future developments in perioperative pharmacy practice are discussed, including technological advancements, improved predictive models, and expansion of collaborative practice agreements.

Perioperative Pain Management and Opioid Stewardship: A Practical Guide

“…It has long been recognized that successful perioperative care involves interdisciplinary collaboration among surgeons, anesthetists, medicine physicians, nurses, and physical therapy providers. Perhaps historically underrecognized has been the value of the clinical pharmacist in improving perioperative patient outcomes and efficiencies [ 526 ]. Despite well-supported benefits to diverse patient outcomes and care teams, pharmacists may be underutilized in postoperative pain management.…”

Enhanced Recovery: A Decade of Experience and Future Prospects at the Mayo Clinic

“…Another example may be when the Pharmacist may recognize that a certain amount of opioid medication was a signal for reassessment—patients requiring more than the usual needed attention. This attention can afford a new diagnosis of a complication or a reassessment in partnership with the pharmacist for another multimodal option and work to taper the opioid effectively [ 37 , 38 , 55 , 56 ].…”

Standard of practice in surgery and perioperative medicine for pharmacy services

“…at the preoperative, intraoperative and postoperative surgical pathway points). [7][8][9][10] The scope of practice of specialised surgery and perioperative medicine pharmacists and their role in medication management are increasingly being recognised. Evolving literature demonstrates improvements surgery and perioperative medicine pharmacists can make to medication management by:…”

“…Clinical pharmacists, as part of the surgical and perioperative MDT, can minimise medicine‐related harm during transitions of care (e.g. at the preoperative, intraoperative and postoperative surgical pathway points) 7–10 . The scope of practice of specialised surgery and perioperative medicine pharmacists and their role in medication management are increasingly being recognised.…”