Surgical pharmacy: the knowledge system of surgical pharmacists

Zheng, Zhihua Christoph; Wu, Junyan; Li, Wei; Li, Xiaoyan; Jiang, Bo; Wu, Hongwei

doi:10.1136/ejhpharm-2021-002887

Cited by 5 publications

(2 citation statements)

References 4 publications

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“…Then, in 2019, through our unremitting effort, the consensus of medical experts on the management of perioperative medication therapy in ERAS in China was published [ 17 ]. In 2021, the GDPA established a new discipline termed “surgical pharmacy”, which is the knowledge system of surgical pharmacists [ 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

Surgical Pharmacy for Optimizing Medication Therapy Management Services within Enhanced Recovery after Surgery (ERAS®) Programs

Xie

Huang

Gao

et al. 2023

JCM

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Drug-related problems (DRPs) are common among surgical patients, especially older patients with polypharmacy and underlying diseases. DRPs can potentially lead to morbidity, mortality, and increased treatment costs. The enhanced recovery after surgery (ERAS) system has shown great advantages in managing surgical patients. Medication therapy management for surgical patients (established as “surgical pharmacy” by Guangdong Province Pharmaceutical Association (GDPA)) is an important part of the ERAS system. Improper medication therapy management can lead to serious consequences and even death. In order to reduce DRPs further, and promote the rapid recovery of surgical patients, the need for pharmacists in the ERAS program is even more pressing. However, the medication therapy management services of surgical pharmacy and how surgical pharmacists should participate in ERAS programs are still unclear worldwide. Therefore, this article reviews the main perioperative medical management strategies and precautions from several aspects, including antimicrobial agents, antithrombotic agents, pain medication, nutritional therapy, blood glucose monitoring, blood pressure treatment, fluid management, treatment of nausea and vomiting, and management of postoperative delirium. Additionally, the way surgical pharmacists participate in perioperative medication management, and the relevant medication pathways are explored for optimizing medication therapy management services within the ERAS programs. This study will greatly assist surgical pharmacists’ work, contributing to surgeons accepting that pharmacists have an important role in the multidisciplinary team, benefitting medical workers in treating, counseling, and advocating for their patients, and further improving the effectiveness, safety and economy of medication therapy for patients and promoting patient recovery.

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Section: Introductionmentioning

confidence: 99%

Surgical Pharmacy for Optimizing Medication Therapy Management Services within Enhanced Recovery after Surgery (ERAS®) Programs

Xie

Huang

Gao

et al. 2023

JCM

Self Cite

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“…Postoperative pain management is one of the key members of surgical pharmacy ( Zheng et al, 2020a ; Wang et al, 2023 ; Zheng et al, 2023 ). Postoperative pain is the acute pain that occurs immediately after surgery.…”

Section: Introductionmentioning

confidence: 99%

Evaluating clinical pharmacists’ involvement in postoperative acute pain services: a multicenter survey in Guangdong Province, China

Lu,

Chen,

et al. 2023

Front. Pharmacol.

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Objective: Postoperative pain management is an important part of surgical pharmacy. Postoperative acute pain services in China are in their initial stages. This survey aimed to investigate the attitudes, involvement, and knowledge of clinical pharmacists in China regarding postoperative acute pain services. The results can provide valuable information to guide clinical pharmacists in developing targeted strategies to improve their postoperative acute pain service capabilities.Methods: A questionnaire was distributed to the pharmacy departments of 133 grade A tertiary hospitals in Guangdong province, and the responses were collected electronically.Results: 123 completed questionnaires were collected from clinical pharmacists. Although 95.93% of clinical pharmacists believed they should participate in postoperative pain services, only 62.6% reported substantial involvement. Overall satisfaction with the postoperative pain service was 93.5%. Understanding of non-steroidal anti-inflammatory drugs and opioid analgesics by clinical pharmacists was comparable (p > 0.05). Furthermore, 98.37% of clinical pharmacists desired systematic learning in postoperative pain management, and 40.65% expressed a strong need.Conclusion: Clinical pharmacists in China demonstrate a positive attitude toward participating in postoperative acute pain services. However, the actual level of involvement was concerning, and the lack of systematic training and well-established work protocols may be contributing factors. Efforts should be made to establish comprehensive and standardized processes and work protocols for postoperative acute pain services and provide systematic and hierarchical professional training to enhance clinical pharmacists’ capabilities in postoperative acute pain services.

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The effect of pharmacist-initiated perioperative multidisciplinary pharmaceutical care model and clinical pathway on pain management in patients undergoing orthopedic surgery: a before-after study

Wang,

Liu,

Feng

et al. 2023

Int J Clin Pharm

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BackgroundPoor pain control is common in perioperative orthopedic surgeries. However, there is a lack of exploration of the clinical pharmacy practice model for this population. AimTo construct a perioperative pharmaceutical care model and clinical pathway for patients undergoing orthopedic surgeries and evaluate their impact on pain management. MethodThis historical before-and-after study was conducted in the Department of Orthopedics of a tertiary hospital in Guangdong Province, China. The control group was surgical patients who received routine diagnosis and treatment. The intervention group received pain management from a multidisciplinary team based on a pharmacist-initiated pharmaceutical care practice model and clinical pathways for medication management. The primary outcome measures were postoperative pain at rest (PAR) and movement-evoked pain (MEP) scores, number of breakthrough pains, and length of hospital stay. ResultsA total of 320 orthopedic surgery patients were included in the study. Among patients with expected moderate or severe postoperative pain (82.5%), signi cantly lower PAR and MEP scores were observed in the intervention group 24 hours after the operation compared to the control group (P<0.05). Compared to the control group, hospital stay in the intervention group was shortened by 2.3 days (P<0.001). However, there were no signi cant differences in the control of breakthrough pain and the incidence of adverse drug reactions (P>0.05). ConclusionPharmacist-initiated multidisciplinary perioperative pain management practice models and clinical pathways could improve outcome indicators related to pain management and realize the role and value of pharmacists.

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Surgical pharmacy: the knowledge system of surgical pharmacists

Cited by 5 publications

References 4 publications

Surgical Pharmacy for Optimizing Medication Therapy Management Services within Enhanced Recovery after Surgery (ERAS®) Programs

Surgical Pharmacy for Optimizing Medication Therapy Management Services within Enhanced Recovery after Surgery (ERAS®) Programs

Evaluating clinical pharmacists’ involvement in postoperative acute pain services: a multicenter survey in Guangdong Province, China

The effect of pharmacist-initiated perioperative multidisciplinary pharmaceutical care model and clinical pathway on pain management in patients undergoing orthopedic surgery: a before-after study

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