The prevalence of chronic medication therapy problems and pharmacists’ interventions among hospitalized perioperative patients: a retrospective observational study

Abstract

Background Inadequate preoperative management of chronic medications can place perioperative patients at risk and cause unnecessary delays in surgical procedures. This study aims to investigate the prevalence of chronic medication therapy problems (CMTPs) in hospitalized perioperative patients and assess the relevance of pharmacists’ interventions. Methods We conducted a retrospective study of pharmacist-led preoperative management of chronic medications in hospitalized adult patients from November 2018 to April 2019. The recorded drug-related problems (DRPs) were retrospectively reviewed and categorized according to the Pharmaceutical Care Network Europe classification V9.1 and were analyzed with a multinomial regression model to identify risk factors. Results A total of 254 DRPs were recorded, with an average of 0.52 DRPs per patient. Treatment safety (66.9%) was the most common DRP. The most frequent causes of perioperative DRPs and nonperioperative DRPs were drug selection (72.9%) and patient related (50.8%), respectively. Of the 292 documented interventions, 71.6% were fully accepted by the clinicians and patients. The majority (68.9%) of the recorded problems were completely resolved. The number of comorbidities (OR = 3.815) and the number of chronic medications taken (OR = 1.539) were risk factors for the occurrence of DRPs. Conclusion The findings of this study suggest that pharmacist-led chronic medication therapy management in surgical wards may be an effective method to help reduce medication-related surgical risks and optimize the medication therapies used for the long-term treatment of chronic diseases.

Best Possible Medication History Collection by Clinical Pharmacist in a Preoperative Setting: An Observational Prospective Study

“…Opioid doses are then adjusted based on the patient's tolerance and adverse effects. During the postoperative period, the patient receives medication monitoring, withdrawal of strong opioids, and counseling [19]. Furthermore, the pharmacist is able to understand and participate in the analysis of the main causes of surgical complications: in fact, our study demonstrated the possibility of decreasing the risk of medication errors due to incorrect medication prescription or an inaccurate, incomplete, or absent medical history prior to hospitalization [20].…”

“…The role of the pharmacist during surgical procedures is indisputably necessary for efficient healthcare delivery and positive patient outcomes. Indeed, the perioperative pharmacist has advanced therapeutic knowledge and experience to ensure the appropriate use of drugs and patient outcomes during the preoperative, intraoperative, and postoperative phases for all surgical patients [19]. During the preoperative period, the pharmacist ensures fluid status optimization, appropriate analgesia administration, antimicrobial prophylaxis, and venous thromboembolism prophylaxis.…”

Global research trends and hotspots in pharmaceutical care: a bibliometric analysis and visualisation using CiteSpace and VOSviewer

“…The distribution of pharmacists’ clinical departments and the absence of the role of clinicians lead to relatively few pharmacists participating in drug education activities 3. In daily diagnosis and treatment, it is difficult for most inpatients and outpatients to get pharmaceutical service from professional pharmacists, which results in patients repeating or seriously abusing drugs, and even mutual antagonism of drug efficacy and many adverse events 4–6…”

“…3 In daily diagnosis and treatment, it is difficult for most inpatients and outpatients to get pharmaceutical service from professional pharmacists, which results in patients repeating or seriously abusing drugs, and even mutual antagonism of drug efficacy and many adverse events. [4][5][6] In recent years, in order to reduce the incidence of adverse drug reactions and to improve the prognosis and satisfaction of patients, the patient-centred…”

Development of service standards and manpower calculation criteria for hospital clinical pharmacies in South Korea: a survey-based study

“…In addition, the role of clinical pharmacists was demonstrated in terms of the reduction of potential prescribing errors, improvement of treatment effects [3][4][5][6], and economic evaluation [4,5]. Clinical pharmacy services are recognized not only in Korea but also worldwide by hospital pharmacists as an essential part of their work, and many are interested in strategies to promote their implementation based on country-speci c analyses [7][8][9][10][11][12][13][14][15][16] .…”