Effect of pharmacist-led medication review on drug-related problems among outpatients undergoing elective surgery at a tertiary care hospital: A retrospective study
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Abstract
Few studies have examined drug-related problems among patients before surgery, including the influence of herbal supplements and dietary products on anaesthetic and surgery outcomes. The primary objective was to measure the prevalence of drug-related problems in outpatients before surgery. The secondary objectives were to investigate the types of herbal supplements and dietary products that might affect anaesthetic and surgical outcomes. Additional aims included exploring factors influencing drug-related problems. This retrospective study was conducted at the preoperative assessment centre. Outpatients aged 18 years or older, who were scheduled for elective surgery, were enrolled. Of 1,440 patients, 27.5% had at least one drug-related problem. The most common category involved medication appropriateness, with herbal supplements and dietary products being the most frequently implicated, particularly among females and those aged 60 years or older (p < 0.001). Multivariate analysis also showed a trend towards an increased occurrence of drug-related problems in patients aged 60 years or older. The findings of this study suggest that pharmacist-led medication review in pre-operative patients may be an effective method to reduce surgical risks associated with medications, herbal supplements, and dietary products; prevent surgical postponement; and optimize the management of chronic diseases, particularly in elderly patients.
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References
Alshimemeri, A., Al-Mishari, H., Shoukry, E., Ali, E., & Metawe, M. (2024). A young adult male with postoperative bleeding following bariatric surgery. Critical Care and Shock, 27(3), 141–144.
American Society of Anesthesiologists. (2020). Herbal and dietary supplements and anesthesia. https://madeforthismoment.asahq.org/wp-content/uploads/2020/10/ASA_Supplements-Anesthesia_Updated-1.pdf
Barqawi, A., Egbaria, A., Omari, A., Abubaji, N., Abushamma, F., Koni, A. A., & Zyoud, S. H. (2024). The use of complementary and alternative medicine among surgical patients: A cross-sectional study. Perioperative Medicine, 13(1), Article 110. https://doi.org/10.1186/s13741-024-00468-7
Bedi, H. S., Tewarson, V., & Negi, K. (2016). Bleeding risk of dietary supplements: A hidden nightmare for cardiac surgeons. Indian Heart Journal, 68(Suppl. 2), S249–S250. https://doi.org/10.1016/j.ihj.2016.03.028
Boonsawek, B., Supan, W., Sombood, P., & Vichitvejpaisal, P. (2023). Drug interaction of andrographis paniculata in anesthesia. The Journal of Chulabhorn Royal Academy, 5(1), 35–43.
Choi, E., Oh, J., & Sung, G.-H. (2020). Antithrombotic and antiplatelet effects of Cordyceps militaris. Mycobiology, 48(3), 228–232. https://doi.org/10.1080/12298093.2020.1763115
Clinical Excellence Commission. (2019). A guide to medication reviews for NSW health services 2019. https://www.cec.health.nsw.gov.au/__data/assets/pdf_file/0016/554110/A-Guide-to-Medication-Reviews-for-NSW-Health-Services-2019.PDF
Cummings, K. C., Keshock, M., Ganesh, R., Sigmund, A., Kashiwagi, D., Devarajan, J., Grant, P. J., Urman, R. D., & Mauck, K. F. (2021). Preoperative management of surgical patients using dietary supplements: Society for perioperative assessment and quality improvement (SPAQI) consensus statement. Mayo Clinic Proceedings, 96(5), 1342–1355. https://doi.org/10.1016/j.mayocp.2020.08.016
de Lorenzo-Pinto, A., Ortega-Navarro, C., Ribed, A., Giménez-Manzorro, Á., Ibáñez-García, S., de Miguel-Guijarro, Á., Ginel-Feito, M. D., Herranz, A., & Sanjurjo-Sáez, M. (2019). Cancellations of elective surgical procedures due to inadequate management of chronic medications. Journal of Clinical Pharmacy and Therapeutics, 44(4), 561–564. https://doi.org/10.1111/jcpt.12816
Deawjaroen, K., Sillabutra, J., Poolsup, N., Stewart, D., & Suksomboon, N. (2022). Characteristics of drug-related problems and pharmacist’s interventions in hospitalized patients in Thailand: A prospective observational study. Scientific Reports, 12, Article 17107. https://doi.org/10.1038/s41598-022-21515-7
Dippenaar, J. M. (2015). Herbal and alternative medicine: The impact on anesthesia. Southern African Journal of Anaesthesia and Analgesia, 21(1), 8–13. https://doi.org/10.1080/22201181.2015.1013321
Elvir Lazo, O. L., White, P. F., Lee, C., Cruz Eng, H., Matin, J. M., Lin, C., Del Cid, F., & Yumul, R. (2024). Use of herbal medication in the perioperative period: Potential adverse drug interactions. Journal of Clinical Anesthesia, 95, Article 111473. https://doi.org/10.1016/j.jclinane.2024.111473
Haag, J. D., Bellamkonda, V. R., Perinpam, L., Peters, B. J., Sunga, K. L., Gross, C. L., Dierkhising, R. A., Baudoin, M. R., & Rudis, M. I. (2022). Prevalence and categorization of drug-related problems in the emergency department. The Journal of Emergency Medicine, 63(2), 192–199. https://doi.org/10.1016/j.jemermed.2022.04.016
Lau, A.-J., Toh, D.-F., Chua, T.-K., Pang, Y.-K., Woo, S.-O., & Koh, H.-L. (2009). Antiplatelet and anticoagulant effects of Panax notoginseng: Comparison of raw and steamed Panax notoginseng with Panax ginseng and Panax quinquefolium. Journal of Ethnopharmacology, 125(3), 380–386. https://doi.org/10.1016/j.jep.2009.07.038
Leung, J. M., Dzankic, S., Manku, K., & Yuan, S. (2001). The prevalence and predictors of the use of alternative medicine in presurgical patients in five California hospitals. Anesthesia & Analgesia, 93(4), 1062–1068. https://doi.org/10.1097/00000539-200110000-00053
Marx, W., McKavanagh, D., McCarthy, A. L., Bird, R., Ried, K., Chan, A., & Isenring, L. (2015). The effect of ginger (Zingiber officinale) on platelet aggregation: A systematic literature review. PLoS ONE, 10(10), Article e0141119. https://doi.org/10.1371/journal.pone.0141119
Mohammed, M., Bayissa, B., Getachew, M., & Adem, F. (2022). Drug-related problems and determinants among elective surgical patients: A prospective observational study. SAGE Open Medicine, 10, 1–10. https://doi.org/10.1177/20503121221122438
Ozsaker, E., Cengiz, H., & Pursal, M. (2024). Investigation of herbal products used by patients before surgery. Progress in Health Sciences, 14(1), 7–14. https://doi.org/10.5604/01.3001.0054.6291
Peterson, C., & Gustafsson, M. (2017). Characterisation of drug-related problems and associated factors at a clinical pharmacist service-naïve hospital in Northern Sweden. Drugs - Real World Outcomes, 4(2), 97–107. https://doi.org/10.1007/s40801-017-0108-7
Pharmaceutical Care Network Europe Association. (2020). PCNE classification for drug-related problems V9.1. https://www.pcne.org/upload/files/417_PCNE_classification_V9-1_final.pdf
Roshanzamiri, S., Farrokhian, A., & Eslami, K. (2017). Incidence of drug related problems in outpatient setting: A review article. Journal of Pharmaceutical Care, 5(3–4), 76–78.
Semcharoen, K., Supornpun, S., Nathisuwan, S., & Kongwatcharapong, J. (2019). Characteristic of drug-related problems and pharmacists’ interventions in a stroke unit in Thailand. International Journal of Clinical Pharmacy, 41(4), 880–887. https://doi.org/10.1007/s11096-019-00832-4
Soós, S. Á., Jeszenői, N., Darvas, K., & Harsányi, L. (2015). Herbal medicine use by surgery patients in Hungary: A descriptive study. BMC Complementary and Alternative Medicine, 15, Article 358. https://doi.org/10.1186/s12906-015-0890-2
Tantipiwattanasakul, K. (2019). The influence of patient factors on medication adherence in ambulatory care unit at Bangplama hospital, Suphanburi. Journal of Health Science, 28(1), S107–S119. [in Thai]
Thummawut, W., & Wongyingsinn, M. (2024). Rate and cause analysis of surgical case cancellation related to medications in a university hospital. Thai Journal of Pharmacy Practice, 16(1), 283–294. [in Thai]
Wickman, K., Dobszai, A., Modig, S., Borgström Bolmsjö, B., Caleres, G., & Lenander, C. (2022). Pharmacist-led medication reviews in primary healthcare for adult community-dwelling patients – a descriptive study charting a new target group. BMC Primary Care, 23(1), Article 237. https://doi.org/10.1186/s12875-022-01849-x
