ArticlePloS one2026
Application and evaluation of a quality indicator system for pharmaceutical care in orthopedic perioperative pain management.
Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThis study aimed to implement a previously developed quality indicator system for pharmaceutical care in orthopedic perioperative pain management and evaluate its impact on adherence to pharmaceutical care standards.
methodsA single-center before-and-after study with a historical control was conducted in 200 patients scheduled for elective orthopedic surgery. Pharmaceutical care quality was assessed using an established indicator system-developed in prior methodological work via the Delphi method and Analytic Hierarchy Process-in combination with the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS). A retrospective pre-intervention cohort (n = 100, Nov 2024-Jan 2025) was evaluated to establish a reference, followed by targeted interventions. A prospective post-intervention cohort (n = 100, Apr-Jun 2025) was then evaluated. Groups were compared on overall adherence (Ci ≥ 0.6) to pharmaceutical care standards and full-score attainment rates of quality indicators. A sensitivity analysis was performed to assess the impact of documentation bias. Bonferroni correction was applied for multiple comparisons.
resultsOverall adherence increased from 41% to 91% (risk difference, 50 percentage points; 95% CI, 37.83-60.05; P < 0.001), with a median difference of 0.32 (95% CI, 0.26-0.38). Sensitivity analysis confirmed the robustness of this finding: even under the most optimistic assumption for missing pre-intervention data, the post-intervention group remained higher (55% vs. 91%, P < 0.001). Four structural indicators showed descriptive improvements, with absolute increases ranging from 34 to 60 percentage points. Of the remaining 16 indicators, multimodal analgesia showed no significant difference (96% vs. 99%, P > 0.05). Among the other 15 process and outcome indicators, 13 remained significant after Bonferroni correction (α = 0.0031), with risk differences ranging from 14 to 33 percentage points. Two outcome indicators-achievement of target resting pain control and breakthrough pain incidence and management-did not reach the adjusted threshold, with improvements of 17 and 10 percentage points, respectively.
conclusionImplementation of a structured quality indicator system was associated with meaningful improvements in pharmaceutical care adherence in orthopedic perioperative pain management. Sensitivity analysis supported the robustness of the finding. Improvements were observed across structural (descriptive), process, and outcome indicators, with the majority of process and outcome indicators showing significant gains after conservative correction. Study limitations include the historical control design, reliance on a composite measure, and single-center setting. These findings provide empirical support and practical reference for implementing structured quality assessment to improve pharmaceutical care adherence.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.