Erik Hefti, PharmD, MS, PhD
Erik Hefti holds a PharmD as well as a Master's and PhD degrees in pharmaceutical science from the University at Buffalo. His research focuses on pediatric pharmacogenomic factors impacting cardiovascular toxicity following cancer chemotherapy and genetic testing utilization to improve healthcare outcomes. His clinical focus involves optimizing pharmacotherapy in patients with genetic disorders. He is the program director and assistant professor of pharmaceutical sciences at Harrisburg University in Harrisburg, PA.
At Sisters of Charity Hospital, St. Joseph Campus in New York, pharmacists have been comprehensively incorporated into pre- and postoperative patient education, focused on medications these individuals will typically receive before and after their respective procedure. Specifically, pharmacists give a formal presentation to preoperative patients prior to undergoing surgery. This presentation focuses on typical medications the patients will be started on following the procedure and details on each drug. This was largely precipitated by the need for a healthcare professional to be available to address the patients’ concerns regarding new medications they would be prescribed. Pharmacists are trusted healthcare professionals who are able to provide high quality information on the safe and effective use of medications, so it was a logical incorporation1.
Over the past few years, we, the pharmacists, have observed an increase in patient apprehension regarding opioid pain medications typically used following surgery. Opiates are frequently used for postoperative pain control, especially for more invasive procedures2. The epidemic of opioid addiction that can start with the use of prescription narcotics is cited as a source of concern. As the opiate crisis continues to grip the country, more patients are worried about starting these medications. They are generally concerned about becoming addicted to opiates if they are started on the medications. Other concerns often cited range from medication side effects to family members stealing prescription narcotics. Pharmacists are in a unique position to assuage and address these legitimate patient concerns. Safe and effective pain management is a major goal in surgical patients. The pharmacists who see these patients discuss strategies to minimize the risk of uncomfortable side effects, addiction, and diversion.
Sisters of Charity pharmacists address the patients’ concerns over existing medication regimens and how they may change following the procedure. Non-opiate drug-related counseling is also performed and often focuses on the safe use of anticoagulants that are commonly prescribed after certain surgical procedures. Observationally, the patients have responded well to pharmacist presence, and we have seen improvements in patient satisfaction. When we considered responses to the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, we began to see modest score increases when considering questions measuring pain control3. Pharmacists in our facility are having a positive impact on patient satisfaction and look to continue the trends we are seeing.
Many hospital pharmacists have fewer opportunities to speak directly with patients. Presurgical and postsurgical education programs represent an excellent opportunity for hospital pharmacists to directly interact with patients in a meaningful way. This benefits everyone involved, from the patient to the facility as a whole. Increased patient satisfaction can positively impact reimbursement rates for the hospital. Pharmacist involvement can also benefit other healthcare professionals and allow them to better care for patients. While pharmacists focus on addressing medication-related issues, nurses and providers can focus on caring for other patient needs. Pharmacists themselves can benefit from increased patient interaction and expanding their profile in the hospital ecosystem.
Overall, incorporating pharmacists into pre- and postoperative patient management and education benefits both patients and healthcare workers. It also represents an excellent avenue for continued pharmacist involvement in healthcare facilities.
- Auyeung V, Patel G, McRobbie D, Weinman J, Davies G. Information about medicines to cardiac in-patients: patient satisfaction alongside the role perceptions and practices of doctors, nurses and pharmacists. Patient education and counseling 2011; 83(3): 360-366.
- Buvanendran A, Fiala J, Patel KA, Golden AD, Moric M, Kroin JS. The incidence and severity of postoperative pain following inpatient surgery. Pain Medicine 2015; 16(12): 2277-2283.
- Hefti E, Remington M, Lavallee C. Hospital consumer assessment of healthcare providers and systems scores relating to pain following the incorporation of clinical pharmacists into patient education prior to joint replacement surgery. Pharmacy practice 2017; 15(4).