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

Objectives The aim of this systematic review was to examine the effectiveness of pre-anaesthetic assessment clinics (PACs) implemented to improve quality and patient safety in perioperative care. Design Systematic review. Data sources The electronic databases CINAHL Plus with Full Text (EBSCOhost), Medline, and Embase (OvidSP) were systematically searched from 1st April, 1996 to 4th February, 2021. Eligibility criteria The main inclusion criterion was that the study, using empirical quantitative methods, addressed the effectiveness of PACs. Data extraction and synthesis Titles, abstracts, and full texts were screened in duplicate by two authors. Risk of bias assessment, using the Joanna Briggs Institute critical appraisal checklist for quasi-experimental studies, and data extraction were performed by one author and checked by the other author. Results were synthesised narratively owing to the heterogeneity of the included studies. Results Seven prospective controlled studies were conducted. Most studies had a high risk of bias. Three studies reported a significant reduction in the length of the 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. 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 ARTICLE SUMMARY Strengths and Limitations of this study Only prospective studies were included in this systematic review. The systematic review was conducted in accordance with international guidelines. Only seven studies were identified, highlighting the need for further research on pre-anaesthetic assessment clinics. Overall, the quality of the included studies was low, and the current practice possesses limited evidence base.