May 1, 2022BMJ Open45 citationsOpen Access

Effectiveness of pre-anaesthetic assessment clinic: a systematic review of randomised and non-randomised prospective controlled studies

EKEirunn Wallevik KristoffersenUniversity of Agder AOAnne OpsalUniversity of Agder TTTor Oddbjørn TveitUniversity of Agder

Structured PICO

Does pre-anaesthesia assessment clinic consultation reduce length of hospital stay and surgery cancellations in surgical patients?

Population

Patients from 7 prospective controlled studies undergoing surgery requiring pre-anaesthetic assessment

Intervention

Pre-anaesthesia assessment clinic (PAC) consultation with the patient present

Comparator

Standard care or no PAC consultation (implied by controlled studies)

Outcome

Quality and safety of perioperative patient care (including length of hospital stay, cancellation of surgery, and patient anxiety)

Pre-anaesthesia assessment clinics may reduce the length of hospital stay and cancellation of surgery, though current evidence is limited by high risk of bias.

Abstract

OBJECTIVES: The aim of this systematic review was to examine the effectiveness of pre-anaesthesia assessment clinics (PACs) in improving the quality and safety of perioperative patient care. DESIGN: Systematic review. DATA SOURCES: The electronic databases CINAHL Plus with Full Text (EBSCOhost), Medline and Embase (OvidSP) were systematically searched on 11 September 2018 and updated on 3 February 2020 and 4 February 2021. ELIGIBILITY CRITERIA: The inclusion criteria for this study were studies published in English or Scandinavian language and scientific original research that included randomised or non-randomised prospective controlled studies. Additionally, studies that reported the outcomes from a PAC consultation with the patient present were included. DATA EXTRACTION AND SYNTHESIS: Titles, abstracts and full texts were screened by a team of three authors. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal checklist for quasi-experimental studies. Data extraction was performed by one author and checked by four other authors. Results were synthesised narratively owing to the heterogeneity of the included studies. RESULTS: Seven prospective controlled studies on the effectiveness of PACs were included. Three studies reported a significant reduction in the length of hospital stay and two studies reported a significant reduction in cancellation of surgery for medical reasons when patients were seen in the PAC. In addition, the included studies presented mixed results regarding anxiety in patients. Most studies had a high risk of bias. CONCLUSION: This systematic review demonstrated a reduction in the length of hospital stay and cancellation of surgery when the patients had been assessed in the PAC. There is a need for high-quality prospective studies to gain a deeper understanding of the effectiveness of PACs. PROSPERO REGISTRATION NUMBER: CRD42019137724.

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