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- Title
Evaluation of pharmacists' role in preoperative medication review in a Veterans Affairs Health Care System.
- Authors
Lindbloom, Tori J; Corbo, Jason M; Blacksmith, Heather P; Tarnowski, Amy; Frei, Christopher R
- Abstract
Purpose Use of high-risk medications preoperatively may increase the incidence of postoperative complications. Available literature evaluating pharmacists' role in preoperative medication review is limited, and guidance is not currently available on which patients should have a medication review performed by a pharmacist before surgery. A preoperative rehabilitation pilot project in which clinical pharmacists reviewed medication profiles before scheduled surgeries was developed. This review aimed to evaluate pharmacists' role in reviewing medication profiles preoperatively and to identify specific patient factors that suggest a medication review is warranted. Methods This retrospective review utilized the electronic medical records of nonfrail adults undergoing preplanned surgeries enrolled in the pilot project from August 2021 to April 2022. Endpoints were determined using descriptive statistics and regression models. A multivariate analysis was performed evaluating high-risk medications and VIONE (Vital, Important, Optional, Not indicated, and Every medication has an indication) polypharmacy risk score. Results Forty patients were included, with at least one recommendation made in 83% of chart reviews. Many patients (95%) were taking at least one high-risk medication. Of the high-risk medication classes evaluated independently, only antiplatelets were predictive of pharmacy intervention (P = 0.01). Only high-risk medications were independently predictive of pharmacist intervention (P < 0.01) when multivariate analysis was performed. Conclusion Pharmacists made a recommendation in the majority of medication reviews and were most likely to make a recommendation in patients taking high-risk medications. A larger sample size may provide more insight regarding patient-specific factors warranting a preoperative medication review.
- Subjects
OCCUPATIONAL roles; FRAIL elderly; PREOPERATIVE period; POLYPHARMACY; MULTIVARIATE analysis; MEDICATION error prevention; RETROSPECTIVE studies; ACQUISITION of data; SURGERY; PATIENTS; REGRESSION analysis; FISHER exact test; MANN Whitney U Test; RISK assessment; MEDICAL records; DESCRIPTIVE statistics; PATIENT care; ELECTRONIC health records; DATA analysis software; PREANESTHETIC medication; UNITED States. Dept. of Veterans Affairs; LONGITUDINAL method
- Publication
American Journal of Health-System Pharmacy, 2024, Vol 81, pS1
- ISSN
1079-2082
- Publication type
Article
- DOI
10.1093/ajhp/zxad291