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Tuesday 25 June 2019
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First national guideline published on the management of medicines in the peri-operative period

The UK Clinical Pharmacy Association (UKCPA) has published the Handbook of Peri-operative Medicines, developed by the UKCPA Surgery & Theatres Group, the first national guidance to professionals working in this area of medicine. The Handbook has been endorsed by the Royal Pharmaceutical Society.


Until now there has been no national guideline in existence for the use of medicines in the peri-operative period. This has resulted in varying practices across the country for the management of patients’ regular medicines during this time.


Many individual NHS Trusts have devised their own local guidelines to provide guidance to medical, nursing and pharmacy staff. However, the lack of a unifying national guidance and support resource has resulted in a range of practices relating to the same medicines but that vary according to location and local preference. Such practice induces an element of risk, confusion and ambiguity across a multitude of treatment centres. The variation in practice is something recognised in the Carter review, which identified that a reduction of such variations will improve patient care and safety through compliance to national guidance.


Sophie Blow, Advanced Clinical Pharmacist specialising in Surgery at Leeds Teaching Hospitals NHS Trust, and project manager for the Handbook, says, “We hope that the Handbook of Peri-operative Medicines, developed collaboratively by clinical pharmacy experts working in the area of Surgery, will remove the need for individual local guidelines and will ultimately reduce variations in patient care and improve outcomes for patients undergoing surgery.”


The Handbook of Peri-operative Medicines has been developed in a format similar to that of other resources used for information on medicines management, such as the Renal Drug Handbook and the Handbook of Drug Administration via Enteral Feeding Tubes. The Handbook contains information on how medicines are to be managed in the peri-operative period, a time when a patient is nil by mouth and often experiences interruption of medication regimens that are important for the treatment of other non-surgical comorbidities. It contains information pertaining to the risks and benefits of omitting, changing and continuing therapy during this period, and where possible how those risks can be managed.


Neal Patel, Head of Corporate Communications at the Royal Pharmaceutical Society says, “We are delighted to endorse this important document, which will provide unified guidance to all health professionals on how medicines should be optimally managed in patients undergoing surgery. Reducing variation in practice will reduce risk and improve patient care and safety. It is a great example of the pharmacy profession working collaboratively and demonstrating leadership to improve patient care.”

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