Evaluation of the current use and impact of the United Kingdom Clinical Pharmacy Association (UKCPA) handbook of perioperative medicines
Authors: Tinsley S , Frank C 
Published: November 2024

Abstract

Introduction
Originally a paper-based resource, the UKCPA Handbook of Perioperative Medicines1 moved online in 2019 and the website was updated in March 2024, with improved functionality. The resource aims to standardise management of medication during the perioperative period by providing evidence-based advice and guidance for healthcare professionals, removing the need for local Trust guidelines.

Aim
To evaluate current use of, and opinions of users of, the UKCPA Handbook of Perioperative Medicines.

Methods
Usage data, including engagement rate and time and frequently accessed monographs, was obtained for 4th-March-2024 to 29th-May-2024 from Google Analytics and the website dashboard. Further usage information and user opinion was collected using a 9-question survey hosted on Survey Monkey and disseminated via UKCPA’s ‘X’ account and Surgery and Theatres Committee, plus NHS England non-medical pre-operative association network. Ethical approval was not required as this was a service evaluation.2

Results
Analytics
Most (79%, 23158) users are from the United Kingdom where the engagement rate is 64%. Outside the UK most users are from Australia (1858), Ireland (785) and the United States (575). The average engagement time is 3-minutes and 42-seconds. Frequently accessed monographs include antiplatelets (aspirin, clopidogrel), direct oral anticoagulants (apixaban, edoxaban) and diabetic medication (sodium glucose co-transporter 2 inhibitors, insulin).
Survey
Of the 237 responses received, individual question completion rates varied. 72% (170) of respondents were aware of the Handbook of which 89% (151) use it, with 22% (34) having it as their sole resource. Respondents were predominantly from NHS secondary care sector and comprised of pharmacists (24%, 58), pre-assessment nurses (21%, 49) and anaesthetists (19%, 44). Most (84%, 133) users access it via desktop. 85% (132) of respondents either “strongly agreed” or “agreed” that it has a professional appearance, 82% (128) that it has good search functionality and 80% (126) that they could find the required information.

Discussion and conclusion
The Handbook is mostly accessed within the United Kingdom, where it has a good engagement rate.3 However, there is usage on a global scale from countries including Australia, Ireland, USA, NZ, Canada, and Germany. Monographs for medicines considered ‘high-risk’ or where there is potential controversy about their perioperative management are the most accessed.
There is good awareness of the Handbook from respondents, with the majority of those familiar with it using it in their area of work. It is expected that those who are aware of the Handbook would be more likely to respond to the survey. The Handbook is mainly used within the NHS secondary care setting, where most surgical procedures take place. However, it is likely that due to how the survey was disseminated, this influenced the healthcare professional groups that responded.
In general, the Handbook is deemed to have a professional appearance, good search functionality and includes information that healthcare professionals require.
The aim of the Handbook is to provide a standardised, evidence-based resource for healthcare professionals for perioperative medicines management. The survey results indicate that there is still variation in practice with centres choosing to use it in conjunction with other guidelines as opposed to their sole resource.

References
1. United Kingdom Clinical Pharmacy Association. Handbook of Perioperative Medicines [Internet]. UKCPA 2024 [cited 2024 May 31]. Available from https://periop-handbook.ukclinicalpharmacy.org
2. NHS Health Research Authority. Do I need NHS REC review? [Internet]. {updated 2010 September, cited 2024 May 31]. Available from https://hra-decisiontools.org.uk/ethics/.
3. Deflato. What is the engagement rate in Google Analytics (GA4)? [Internet]. Dataflo 2024 [cited 2024 May 31] Available from https://wwwdataflo.io/metricbase/engagement-rate-in-google-analytics-4#:~:text=in%20a%session