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Published on 30 May 2007

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Pharmacist role aids post-op medication

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A combined intervention of pharmacist medication assessments and a postoperative medication order form can reduce postoperative medication discrepancies related to home medications.

Such are the conclusions of the Surgical Pharmacist in Preadmission Clinic Evaluation (SPPACE) study.

In the study, 464 eligible patients who had a preadmission clinic appointment before undergoing surgical procedures were randomly assigned to the intervention arm (structured pharmacist medication history interview with assessment and generation of a postoperative medication order form; n=227), or to the standard-care arm (nurse-conducted medication histories and surgeon-generated medication orders; n=237). The primary endpoint was the number of patients with at least one postoperative medication discrepancy related to home medications.

The study was undertaken over six weeks. In the intervention arm, 41 (20.3%) of 202 patients evaluated had at least one postoperative medication discrepancy related to home medications, compared with 86 (40.2%) of 214 patients in the standard-care arm (p<0.001). In the intervention arm, 26 (12.9%) of 202 patients had at least one postoperative medication discrepancy with the potential to cause possible or probable harm, compared with 64 (29.9%) of 214 patients in the standard-care arm (p<0.001). These were mostly omissions of reordering home medications.

Arch Intern Med 2007;167:1034-40

 



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