Impact of a Surgical Preadmission Clinic Pharmacist on the Quality of Medication Management from Preadmission to Discharge: a Randomised Controlled Study

Background Studies evaluating the impact of surgical preadmission clinic (PAC) pharmacists have reported significant improvements in medication management. However, despite the increased uptake of pharmacy services in this area, randomised controlled studies are limited. Aim To investigate the impact of a surgical PAC pharmacist on the quality of medication management from preadmission to discharge. Method A prospective, randomised, controlled design was used to assign patients to either the intervention or control groups. The intervention group received standard PAC care plus assessment by a PAC pharmacist. The control group received standard PAC care only. Both groups also received standard inpatient care, and were followed from PAC to discharge, and data collected on pharmacist interventions, medication reconciliation and medication history documentation. Results 171 patients were randomised to the intervention group and 184 to the control group. The intervention group had significantly more regular and as required prescription medicines, and complementary and alternative medicines documented per patient than the control group; and significantly more pharmacist interventions (31%) than the control group. The PAC pharmacist made 27% of interventions in the intervention group. Medication reconciliation at admission was 81% for the intervention group and 75% for the control group. Medication reconciliation for both groups was 90% at discharge. Conclusion A surgical PAC pharmacist had a positive impact on medication management through improved quality of medication histories and documentation, interventions and medication reconciliation.