Preoperative Management of Medications for Rheumatologic and HIV Diseases: Society for Perioperative Assessment and Quality Improvement (SPAQI) Consensus Statement |
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| Affiliation: | 1. Department of Rheumatology, Hospital for Special Surgery, New York, NY;2. Department of Medicine, Medical College of Wisconsin, Madison, NY;3. Section of Hospital Medicine, Department of Medicine, Weill Cornell Medical College, New York, NY;4. Department of Medicine, Division of Infectious Diseases, Medical College of Wisconsin, Milwaukee, WI;5. Anesthesiology Institute, Cleveland Clinic Foundation, Cleveland, OH;6. Department of Infectious Diseases, Mayo Clinic, Rochester, MN;7. Department of General Internal Medicine, Mayo Clinic, Rochester, MN;8. Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, MA;9. Department of Anesthesiology, Wake Forest School of Medicine, Winston Salem, NC;10. Department of Anesthesiology, Yale School of Medicine, New Haven, CT;1. School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan;2. Department of Pharmacy, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan;3. School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan;4. Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan;5. Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan;6. Department of Population Health, University of Kansas School of Medicine, Kansas City, KS USA;7. Department of Radiation Oncology, University of Kansas School of Medicine, Kansas City, KS USA;8. Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan;9. Department of Neurology, Taipei Medical University Hospital, Taipei, Taiwan;1. Resident in Internal Medicine, Mayo Clinic School of Graduate Medical Education, Rochester, MN;2. Advisor to residents and Consultant in Cardiovascular Medicine, Mayo Clinic, Rochester, MN;1. Department of Medicine T, Sourasky Medical Center, Tel Aviv, Israel;2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel;3. Department of Medicine B, Assuta Ashdod University Hospital, Ashdod, Israel;4. Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel;5. Department of Rheumatology, Sourasky Medical Center, Tel Aviv, Israel;6. Department of Medicine D, Sourasky Medical Center, Tel Aviv, Israel |
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| Abstract: | Perioperative medical management is challenging because of the rising complexity of patients presenting for surgical procedures. A key part of preoperative optimization is appropriate management of long-term medications, yet guidelines and consensus statements for perioperative medication management are lacking. Available resources use recommendations derived from individual studies and do not include a multidisciplinary focus on formal consensus. The Society for Perioperative Assessment and Quality Improvement identified a lack of authoritative clinical guidance as an opportunity to use its multidisciplinary membership to improve evidence-based perioperative care. The Society for Perioperative Assessment and Quality Improvement seeks to provide guidance on perioperative medication management that synthesizes available literature with expert consensus. The aim of this consensus statement is to provide practical guidance on the preoperative management of immunosuppressive, biologic, antiretroviral, and anti-inflammatory medications. A panel of experts including hospitalists, anesthesiologists, internal medicine physicians, infectious disease specialists, and rheumatologists was appointed to identify the common medications in each of these categories. The authors then used a modified Delphi process to critically review the literature and to generate consensus recommendations. |
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