Perioperative medical emergencies: The role of clinical pharmacists and a review of pharmacotherapy considerations

Hyland, Sara J.; Wolfe, Rachel C.; Patel, Gourang; Johnson, Eric

doi:10.1002/jac5.1762

Cited by 2 publications

(4 citation statements)

References 55 publications

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“…The remainder comprised 14 conference abstracts [115][116][117][118][119][120][121][122][123][124][125][126][127][128], 8 journal columns [129][130][131][132][133][134][135][136], 5 letters to a journal editor [137][138][139][140][141], 3 practice standards or guidelines [25,26,142], 2 opinion papers [24,143], 2 narrative reviews [144,145], and 1 newsletter article [146]. Regarding study design, 58 publications were termed descriptive case studies or reports, i.e.…”

Section: Characteristics Of Included Publicationsmentioning

confidence: 99%

“…[24-26, 50, 66, 72, 78, 83, 111, 122, 126, 131, 133, 137, 142, 145] and medication safety initiatives [24-26, 50, 71, 73, 75, 77, 78, 118, 122, 128, 130, 139, 140]. Pharmacists' involvement in perioperative emergencies was also documented [24,25,65,69,124,144,146], with speci c reference to membership of intraoperative resuscitation teams [69, 124,146] and the management of malignant hyperthermia [65]. Theatre pharmacists were also involved in antimicrobial stewardship [77,81,102,123,124,143,145], practice-based research [25,26,60,66,71,72,78,79,89,100,105,114], and health informatics [59,60,71,115,130,145].…”

Section: Types Of Pharmacy Services To Theatrementioning

confidence: 99%

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Established and emerging theatre pharmacy services: a scoping review

McGowan,

Deasy,

Coyle

et al. 2024

Preprint

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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.

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Section: Characteristics Of Included Publicationsmentioning

confidence: 99%

Section: Types Of Pharmacy Services To Theatrementioning

confidence: 99%

Established and emerging theatre pharmacy services: a scoping review

McGowan,

Deasy,

Coyle

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“… 14 Clinical pharmacists could have unique roles in the perioperative settings owing to their advanced therapeutic knowledge and experience which make them well poised to add value to emergency response efforts as paralleled in other settings. 14 , 15 This could potentially lead to a significant improvement to patient care in terms of both efficacy and safety. 15 …”

Section: Introductionmentioning

confidence: 99%

“… 14 , 15 This could potentially lead to a significant improvement to patient care in terms of both efficacy and safety. 15 …”

Section: Introductionmentioning

confidence: 99%

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

Naseralallah,

Koraysh,

Aboujabal

et al. 2024

Therapeutic Advances in Drug Safety

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Background: The perioperative arena is a unique and challenging environment that requires coordination of the complex processes and involvement of the entire care team. Pharmacists’ scope of practice has been evolving to be patient-centered and to expand to variety of settings including perioperative settings. Objectives: To critically appraise, synthesize, and present the available evidence of the characteristics and impact of pharmacist-led interventions on clinically important outcomes in the perioperative settings. Design: A systematic review and meta-analysis. Methods: We searched PubMed, Embase, and CINAHL from index inception to September 2023. Included studies compared the effectiveness of pharmacist-led interventions on clinically important outcomes (e.g. length of stay, readmission) compared to usual care in perioperative settings. Two independent reviewers extracted the data using the DEPICT-2 (Descriptive Elements of Pharmacist Intervention Characterization Tool) and undertook quality assessment using the Crowe Critical Appraisal (CCAT). A random-effect model was used to estimate the overall effect [odds ratio (OR) for dichotomous and standard mean difference (SMD) for continuous data] with 95% confidence intervals (CIs). Results: Twenty-five studies were eligible, 20 (80%) had uncontrolled study design. Most interventions were multicomponent and continuous over the perioperative period. The intervention components included clinical pharmacy services (e.g. medication management/optimization, medication reconciliation, discharge counseling) and education of healthcare professionals. While some studies provided a minor description in regards to the intervention development and processes, only one study reported a theoretical underpinning to intervention development. Pooled analyses showed a significant impact of pharmacist care compared to usual care on length of stay (11 studies; SMD −0.09; 95% CI −0.49 to −0.15) and all-cause readmissions (8 studies; OR 0.60; 95% CI 0.39–0.91). The majority of included studies ( n = 21; 84%) were of moderate quality. Conclusion: Pharmacist-led interventions are effective at improving clinically important outcomes in the perioperative setting; however, most studies were of moderate quality. Studies lacked the utilization of theory to develop interventions; therefore, it is not clear whether theory-derived interventions are more effective than those without a theoretical element. Future research should prioritize the development and evaluation of multifaceted theory-informed pharmacist interventions that target the whole surgical care pathway.

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Perioperative medical emergencies: The role of clinical pharmacists and a review of pharmacotherapy considerations

Cited by 2 publications

References 55 publications

Established and emerging theatre pharmacy services: a scoping review

Established and emerging theatre pharmacy services: a scoping review

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

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