Palliative care is a product of the modern hospice movement and has evolved significantly in recent decades. The term palliative refers to the relief of pain without dealing with the cause of the condition, and palliative care encompasses the symptomatic care of patients with lifelong conditions to improve the quality of life. Palliative care typically involves a multidisciplinary team to address the various needs of patients, include pharmacists.
Pharmacists can play a vital role in palliative care in several ways, including the timely provision of medications, assessment of medication plans and counseling of the palliative care team.
Ongoing medications are usually a core part of a palliative care treatment plan for the management of symptoms.
It is the responsibility of a pharmacist to ensure that patients have access to the medications required in the management of their health condition in a timely manner. This is important for all patients, but particularly so for those who require palliative care because the medications play a key role in increasing the quantity and quality of life for palliative care patients.
Support to the palliative care team
The hospice or palliative care team responsible for the daily care of the patient is not likely to have the depth of knowledge about the mechanism of action of the medications used that the pharmacist has. Therefore, it is useful for the pharmacist to determine the most relevant points about the use of the medications that the palliative care team should be aware of. This may include administration instructions, possible side effects or cautions about use with other medications or if the patient has another health condition that may impact the safety or efficacy of the drug.
It is also important for the patients and their caregivers to understand the medication administration directions and any side effects that they should seek advice about if they occur. The pharmacist also has a role to play in this scenario.
Detection and management of drug-related problems
Palliative care patients often need to take multiple medications simultaneously and, as a result, have an increased risk of drug interactions and drug-related problems. Pharmacists have more knowledge of medications and their effects than any other member of the healthcare team and are, therefore, the best equipped to detect possible problems and make the appropriate recommendations.
While each health professional in the palliative care team should have basic knowledge about the appropriate use of medications, it is the responsibility of the pharmacist to assess the appropriateness of medications that have been prescribed for patients. If any potential issues are detected, the pharmacist should consult with other members of the team to bring the problem to their attention and suggest alternative recommendations for consideration.
The role of pharmacists in palliative care
Palliative care is a relatively modern concept, and the role of each health professional in the palliative care team is still being established. However, the strengths of pharmacists, such as access to and knowledge of medications, should be utilized in the care team. This should be complemented by the involvement of other health professional with unique skillsets.
References
- http://www.medscape.com/viewarticle/442078_1
- https://www.ashp.org/
- http://theoncologypharmacist.com/top-issues/2015-issues/may-2015-vol-8-no-2/16374-the-pharmacist-s-role-in-hospice-and-palliative-care-and-other-news-from-hopa-s-11th-annual-meeting
- https://pharmaceutical-journal.com/article/letters/community-pharmacists-play-important-role-in-palliative-care
- http://bmcpalliatcare.biomedcentral.com/articles/10.1186/1472-684X-10-16
Further Reading
NYU Langone researchers address the challenges of heart failure in cancer patients