Preoperative Medication Management, Compliance and Adverse Events in Adult Patients Undergoing Elective Surgery: A Historical Chart Review ()
Affiliation(s)
1Department of Anesthesia, McMaster University, Hamilton, ON, Canada.
2Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
3Department of Health Research Methods, Evidence, and Impact, Biostatistics Unit, St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada.
ABSTRACT
Purpose: Medication compliance for chronic medications has been well studied, but there is a gap in the literature regarding compliance within the perioperative period. Our objective was to determine the incidence of patient non-compliance with preoperative medication instructions for adult non-emergent surgery. Additional objectives were to identify predictors of compliance, describe medication instructions by drug type, and explore the impact of non-compliance. Patients and Methods: This historical chart review evaluated preoperative compliance to medication instructions in 393 adults undergoing non-emergent surgeries at Hamilton Health Sciences between May 1, 2012, and April 30, 2013. Seven patient factors (age; sex; American Society of Anesthesiologists class; number of medications; type of surgery; time between preoperative appointment to surgery; the individual collecting the medication list) were evaluated as potential predictors of non-compliance and analyzed using logistic regression analysis. Consequences of non-compliance were assessed by impact on intraoperative blood pressure, blood glucose level, drop in hemoglobin, bronchospasm, and case delays. Results: One hundred forty-six (37.2%) patients were non-compliant with one or more medication reconciliation instructions provided by the anesthesiologist. No significant associations were observed for any patient risk factors and non-compliance. Non-compliance was not associated with any clinically significant consequences. Conclusions: Our study shows that 37.15% of adult patients undergoing non-emergent surgery were non-compliant with medication instructions, although patients did not receive any written instructions for 46% of their medications. We did not identify any predictive patient factors or adverse outcomes associated with non-compliance.
Share and Cite:
Paul, J. , He, H. , Diep, J. , Vanniyasingam, T. and Middleton, S. (2022) Preoperative Medication Management, Compliance and Adverse Events in Adult Patients Undergoing Elective Surgery: A Historical Chart Review.
Open Journal of Anesthesiology,
12, 113-133. doi:
10.4236/ojanes.2022.123011.
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