An audit of regular medication compliance prior to presentation for elective surgery

Patients presenting for elective surgery frequently omit one or more regular medications. There is evidence that withholding some medication classes may lead to harm in the peri-operative period. We aim to quantify medication non-compliance in an adult, elective surgical population and identify the reasons for this non-compliance.

Data was collected over a four-week period at an elective surgical facility on adult patients presenting for surgery. Surgery and anaesthesia type, the names of regular medications and reasons for omission were recorded. This information was matched to pharmacy data for six months prior to the audit.

Six hundred and ninety-two patients underwent surgery during the audit period. Data for 631 patients (91%) was collected. Three hundred and sixty-six (58%) were prescribed regular medications. After exclusion of diabetic medication, 109 patients (30%) had missed one or more regular medications. Thirty-four patients (31%) were non-compliant with medication due to fasting. Twenty-seven patients (25%) were confused. Ten percent and 21% of patients prescribed beta-blockers or calcium channel blockers respectively were non-compliant on the day of surgery.

A significant number of patients were non-compliant with their regular medication on the day of surgery. This represents a preventable source of risk that could be addressed by improved patient education or improved organisational pathways.