Effect of pharmacist-led preoperative medication management on elective surgical cancellation rates and economic implications

Abstract Purpose Although preoperative medication management can prevent surgical cancellations due to inappropriate medication use, the effect of pharmacist-led preoperative medication management on elective surgical cancellation rates and surgical procedure fees remains unclear. In this study, we investigated the effects of pharmacist-led preoperative medication management on elective surgical cancellation rates and the potential economic implications. Methods This retrospective study included cases of elective surgery performed under general anesthesia at Fujita Health University Hospital in 2013, before routine pharmacist involvement, and in 2023, after the routine implementation of pharmacist-led preoperative medication management. Elective surgical cases included both completed elective surgeries and those with a recorded cancellation within 7 days before or after the scheduled elective surgery date. The rates of surgical cancellation owing to inappropriate medication use were calculated and compared among all cases in 2013 and 2023. In 2023, surgical procedure fees were calculated for cases in which changes to preoperative medication instructions were made after pharmacist-initiated queries to physicians. Results There were 3,952 cases in 2013 and 5,880 cases in 2023. The proportion of surgical cancellations due to inappropriate medication management was significantly lower in 2023 (0.05%) than in 2013 (0.3%) (P < 0.01). In 2023, pharmacist-initiated queries to physicians were made in 225 cases (3.8%), after which changes to preoperative medication instructions were made in 181 cases (80.4%). The total surgical procedure fees for the 181 cases were $613,291. Conclusion Pharmacist-led preoperative medication management is associated with fewer surgical cancellations and potential economic benefits.