Comprehensive Analysis of Clinical Pharmacist Interventions in General Surgery: Impact on Patient Safety, Medication Efficacy, and Multidisciplinary Care Outcomes

Abstract

Background: Adverse drug events (ADEs) and medication errors are major perioperative surgical care risks due to complicated medication schedules and frequent care transitions. Involvement of clinical pharmacists in surgical teams is likely to increase the safety of medications, improve therapeutic results, and improve multidisciplinary care coordination.

Methods: A stepped-wedge cluster randomized trial in six general surgery wards for 18 months. Adult patients (≥18 years) who underwent surgery with a ≥24-hour postoperative stay were considered. The intervention bundle by the clinical pharmacist included medication reconciliation, targeted drug reviews, antimicrobial stewardship, patient counselling, and multidisciplinary involvement. The main outcome was the rate of preventable medication-related harm per 1,000 patient-days. Secondary outcomes were medication efficacy, guideline compliance, length of stay, readmissions, and economic assessment.

Results: In 1,280 patients screened, 1,200 were subjected to analysis. The intervention had a 40% decrease in preventable ADEs (13.5 vs. 8.2 per 1,000 patient-days; IRR = 0.60; p < 0.001). There were significant reductions in antimicrobial compliance (65% → 84%), VTE prophylaxis (71% → 89%), mean pain scores (5.8 → 3.9), and median hospital stay (8.2 → 6.4 days). The intervention was found to be cost-effective with an 80% probability at a $2,000 willingness-to-pay threshold.

Conclusion: Organized clinical pharmacist interventions improve patient safety, maximize prescribing, and decrease healthcare utilization while being cost-effective. Engaging pharmacists on surgical care teams is a viable model to enhance perioperative outcomes and foster value-based healthcare delivery.