Established and emerging roles for pharmacy in operating theatres: a scoping review

Pharmacy services at surgical pre-assessment clinics and on inpatient wards are well-documented, but services to theatre appear comparatively under-developed. High-risk and high-cost medicines are used routinely in theatre; pharmacists are well-qualified to optimise their use and improve patient care.

To determine the range, extent and nature of pharmacy services to theatre internationally, and to describe any reported outcomes of these services.

This scoping review was conducted and reported as per PRISMA-ScR and Joanna Briggs Institute methodology. A search was conducted across MEDLINE, Embase, CINAHL, PsycInfo, Bielefeld Academic Search Engine, Canada's Drug and Health Technology Agency, Google and Google Scholar in April 2023. One reviewer screened titles and abstracts. Two reviewers screened full texts. Data extraction was completed by one reviewer. Two reviewers used the Mixed Methods Appraisal Tool (MMAT) to perform quality appraisal. For work completed by one reviewer, a 10% sample was randomly selected for screening by a second reviewer.

Ninety-two publications were included from 3924. Fifty-seven were primary research articles. Other publication types included conference abstracts, journal columns, letters to the editor, practice standards/guidelines, opinion papers, narrative reviews and newsletter articles. Medication management and clinical services across five continents were described. Most reported outcomes related to cost savings. Nine of the 57 articles met the criteria for MMAT appraisal: of these, adherence to quality criteria ranged from 40 to 100%.

Evidence for theatre pharmacy services is extensive and varied. Empirical research of high methodological quality is required to assess the outcomes of these services.