MAYOTHEMATIC REVIEW ON PERIOPERATIE MEDICINECLINIGPreoperative Management of Medications forCheck for updatesRheumatologic and HIV Diseases:Society forPerioperative Assessment and QualityImprovement(SPAQI)Consensus StatementLinda A.Russell,MD:Chad Craig,MD;Eva K.Flores,MD;J.Njeri Wainaina,MD;Maureen Keshock,MD,MHSA;Mary J.Kasten,MD;David L.Hepner,MD,MPH;Angela F.Edwards,MD;Richard D.Urman,MD,MBA;Karen F.Mauck,MD,MSc;and Adriana D.Oprea,MDAbstractPerioperative medical management is challenging because of the rising complexity of patients presentingfor surgical procedures.A key part of preoperative optimization is appropriate management of long-termmedications,yet guidelines and consensus statements for perioperative medication management arelacking.Available resources use recommendations derived from individual studies and do not include amultidisciplinary focus on formal consensus.The Society for Perioperative Assessment and QualityImprovement identified a lack of authoritative clinical guidance as an opportunity to use its multidisci-plinary membership to improve evidence-based perioperative care.The Society for Perioperative Assess-ment and Quality Improvement seeks to provide guidance on perioperative medication management thatsynthesizes available literature with expert consensus.The aim of this consensus statement is to providepractical guidance on the preoperative management of immunosuppressive,biologic,antiretroviral,andanti-inflammatory medications.A panel of experts including hospitalists,anesthesiologists,internalmedicine physicians,infectious disease specialists,and rheumatologists was appointed to identify thecommon medications in each of these categories.The authors then used a modified Delphi process tocritically review the literature and to generate consensus recommendations.2022 Published by Elsevier Inc on behalf of Mayo Foundation for Medical Education and Research Mayo Clin Proc.2022:97(8):1551-1571he variety of immunosuppressantinternal medicine physicians,infectious dis-medications,biologic medications,ease specialists,and rheumatologists)to re-antiretrovirals,andnonsteroidalview available literature and to createFrom the Department ofanti-inflammatory drugs (NSAIDs)hasconsensus recommendations for the periop-Rheumatology.Hospitalfor Special Surpery.Newgrown significantly during the past 2 de-erative management of medications usedYork NY (LARcades.Decisions about their perioperativefor rheumatologic and human immunodefi-Department of Medicine.Medical College of Wis-management can be challenging as thereciency virus (HIV)disease.The guidance ofconsin.Madison (CCare often benefits and risks associated withwhether to continue or to discontinue theseSection of Hospital Medi-continuation and discontinuation of thesemedications is based on the potential harmcine Department ofMedicine,Weill Comellmedications in the perioperative period.to the patient,if the medication is held,Medical College NewBecause guidance is often lacking,the
