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Positive Patient Postoperative Outcomes with Pharmacotherapy: A Narrative Review including Perioperative-Specialty Pharmacist Interviews.

作者信息

Parrish Richard H, Bodenstab Heather Monk, Carneal Dustin, Cassity Ryan M, Dager William E, Hyland Sara J, Lovely Jenna K, Pollock Alyssa, Sparkes Tracy M, Wong Siu-Fun

机构信息

Department of Biomedical Sciences, Mercer University School of Medicine, Columbus, GA 31902, USA.

Department of Medical Science, Sobi Pharma, Waltham, MA 02451, USA.

出版信息

J Clin Med. 2022 Sep 24;11(19):5628. doi: 10.3390/jcm11195628.


DOI:10.3390/jcm11195628
PMID:36233497
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9572852/
Abstract

The influence of pharmacotherapy regimens on surgical patient outcomes is increasingly appreciated in the era of enhanced recovery protocols and institutional focus on reducing postoperative complications. Specifics related to medication selection, dosing, frequency of administration, and duration of therapy are evolving to optimize pharmacotherapeutic regimens for many enhanced recovery protocolized elements. This review provides a summary of recent pharmacotherapeutic strategies, including those configured within electronic health record (EHR) applications and functionalities, that are associated with the minimization of the frequency and severity of postoperative complications (POCs), shortened hospital length of stay (LOS), reduced readmission rates, and cost or revenue impacts. Further, it will highlight preventive pharmacotherapy regimens that are correlated with improved patient preparation, especially those related to surgical site infection (SSI), venous thromboembolism (VTE), nausea and vomiting (PONV), postoperative ileus (POI), and emergence delirium (PoD) as well as less commonly encountered POCs such as acute kidney injury (AKI) and atrial fibrillation (AF). The importance of interprofessional collaboration in all periprocedural phases, focusing on medication management through shared responsibilities for drug therapy outcomes, will be emphasized. Finally, examples of collaborative care through shared mental models of drug stewardship and non-medical practice agreements to improve operative throughput, reduce operative stress, and increase patient satisfaction are illustrated.

摘要

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[1]
Antimicrobial Stewardship in Total Joint Arthroplasty: Outcomes of a Collaborative Program Implementation.

J Am Acad Orthop Surg. 2022-10-15

[2]
Managing a perioperative medicine program.

Best Pract Res Clin Anaesthesiol. 2022-8

[3]
Perioperative Management of Antithrombotic Therapy: An American College of Chest Physicians Clinical Practice Guideline.

Chest. 2022-11

[4]
Improving safety and efficacy with pharmacist medication reconciliation in orthopedic joint surgery within an enhanced recovery after surgery program.

BMC Health Serv Res. 2022-4-6

[5]
Usefulness of criteria for intraoperative Management of Postoperative Nausea and Vomiting.

J Pharm Health Care Sci. 2022-4-4

[6]
Preoperative oral carbohydrate loading: Effects on intraoperative blood glucose levels, post-operative nausea and vomiting, and intensive care unit stay.

J Anaesthesiol Clin Pharmacol. 2021

[7]
Sugammadex enhances recovery after abdominal surgery in cancer patients: a real-world, observational study.

Ann Palliat Med. 2021-12

[8]
Pharmacotherapeutic prophylaxis and post-operative outcomes within an Enhanced Recovery After Surgery (ERAS®) program: A randomized retrospective cohort study.

Ann Med Surg (Lond). 2021-12-14

[9]
Enhanced recovery after surgery: Current status and future progress.

Best Pract Res Clin Anaesthesiol. 2021-12

[10]
Efficacy of perioperative pharmacological and regional pain interventions in adult spine surgery: a network meta-analysis and systematic review of randomised controlled trials.

Br J Anaesth. 2022-1

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