Established and emerging theatre pharmacy services: a scoping review

Abstract

Background Pharmacy services impact patients throughout the perioperative journey. Pharmacist activities at surgical pre-assessment clinics and on inpatient wards are well-documented, but services to theatre appear comparatively under-developed. High-risk and high-cost medicines are used routinely in theatre; pharmacists are well-placed to optimise their use and improve patient care.Aim To determine the range, extent and nature of theatre pharmacy services and their outcomes.Method This scoping review was conducted and reported as per the Joanna Briggs Institute methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. A search was conducted across electronic and grey literature databases to identify pharmacy theatre services. One reviewer screened titles and abstracts and carried out data extraction, with a 10% sample screened by a second reviewer. Two reviewers evaluated full texts. Quality appraisal was undertaken using the Mixed Methods Appraisal Tool.Results Ninety-two publications were included from 3924 search results. Fifty-seven were primary research articles. Most of the included publications described services in the United States of America; the remainder were from Australia, several European countries, Egypt, Morocco, Japan, China and Taiwan. Theatre pharmacy services included medication management and various clinical activities. Outcomes related to cost savings, patient safety and staff satisfaction. Nine of the 57 articles were suitable for quality appraisal. Adherence to quality criteria ranged from 40–100%.Conclusion Evidence for theatre pharmacy services is extensive and varied. Empirical research of high methodological quality is required to assess the outcomes of these services.