title: A cross-sectional study of preoperative medication adherence and early postoperative recovery.
abstract: OBJECTIVE
  To quantify the impact of preoperative medication adherence on recovery length of stays and complication rates.
  
  
  METHODS
  Cross-sectional analytical study.
  
  
  METHODS
  Postanesthetic care unit (PACU) of a single-center tertiary hospital.
  
  
  METHODS
  Surgical patients admitted for surgery at our institution over a 4-month period.
  
  
  METHODS
  A data collection tool was used to collect demographic data, length of stay in recovery, prespecified conditions likely to impact on PACU recovery (chronic pain, insulin-dependent diabetes, epilepsy, hypertension, on a methadone program, and Parkinson disease), medication compliance, and complications in PACU.
  
  
  METHODS
  Differences among categorical variables were assessed for significance using the χ2test; continuous parametric data were compared using a time to survival analysis via Kaplan-Meier estimates and Cox proportional hazard regressions to account for possible confounders.
  
  
  RESULTS
  Preoperative medication compliance for the prespecified conditions was 65.1%. Patients with a preoperative condition spent more time in the PACU compared to patients without a preoperative condition. Time in PACU was not significantly longer for patients who took their medications compared to those who failed to take their medications. Patients with multiple prespecified conditions were more likely to incur a postoperative complication compared to patients without a prespecified condition. Patients with preoperative hypertension and insulin-dependent diabetes incurred higher complication rates in PACU for medication nonadherence compared to medication adherence.
  
  
  CONCLUSIONS
  This study taken together with accruing evidence suggests that preoperative medication omission remains an ongoing issue that can influence complication rates in the PACU. Patients with preoperative conditions stay longer in PACU, and medication omission was associated with higher rates of certain postoperative complications in PACU. This identifies patients likely to require more interventions and greater recovery resources. Further research into the impact of medication omission on recovery parameters after discharge from the PACU is warranted.
authors.affiliation: Concord Hospital, Sydney, Australia.
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Notaras
authors.affiliation: Post-anesthesia Care Unit, St Vincent's Hospital, Sydney, Australia.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Demetriou
authors.affiliation: Post-anesthesia Care Unit, St Vincent's Hospital, Sydney, Australia.
authors.forename: Jessica
authors.initials: J
authors.lastname: Galvin
authors.affiliation: St Vincent's Hospital, Sydney, Australia; Notre Dame University, Sydney, Australia. Electronic address: erezben@yahoo.com.
authors.forename: Erez
authors.initials: E
authors.lastname: Ben-Menachem
mesh_terms: D000328:Adult; D000368:Aged; D000762:Anesthesia Recovery Period; D000765:Anesthesia, Conduction; D000768:Anesthesia, General; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D007902:Length of Stay; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010147:Pain Measurement; D010351:Patient Discharge; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D057234:Preoperative Period; D013514:Surgical Procedures, Operative
keywords: Anesthetic; Complications; Cost-effectiveness; Medication administration