Abstract
Introduction: The Centre for Perioperative Care Guidelines for People Living with Frailty emphasises the need for routine frailty assessment and subsequent Comprehensive Geriatric Assessment (CGA) in older adults within the emergency surgical setting. Medication review and optimisation is an integral part of the CGA. The Scottish Government’s Polypharmacy Guidance provides a 7 steps structure for patient-centred medication reviews. Utilising this structure, our aim was to establish a standardised method for documentation and recording of medication reviews as part of CGAs undertaken by our organisation’s perioperative frailty team.
Methods: Our perioperative frailty team aim to screen all adults aged ≥ 65 years within the Acute Surgical Receiving Unit (ASRU). A medication review including identification of polypharmacy forms part of this process. Older adults living with frailty, particularly those with polypharmacy were prioritised for a standardised medication review (SMR). The introduction of an electronic prescribing system in our organisation allowed for the ability to record SMRs and utilise the prescribing dashboard to retrospectively identify the number of SMRs performed.
Results: Data was collected over an 8 week period in April and May 2025. During these 8 weeks, 317 patients were screened for frailty on admission to ASRU. Patients were admitted as emergencies under the care of general surgery, vascular surgery and urology. The mean Clinical Frailty Scale score was 4.0. An SMR was recorded by our team on 138 of these patients.
Conclusion: The introduction of electronic prescribing in our hospital has given us the opportunity to document and record our medication reviews in a standardised format. Patients have been receptive and engaged with the opportunity to review their medications. Future plans include analysis of interventions made during the SMRs using the prescribing dashboard and use of this data to support with securing dedicated pharmacist support to our perioperative frailty team.