Consultation-Based Deprescribing Service to Optimize Palliative Care for Terminal Cancer Patients

Abstract

(1) Background: A pharmacist-led deprescribing service previously developed within the Consultation-Based Palliative Care Team (CB-PCT) was implemented for terminal cancer patients. (2) Objective: To evaluate the clinical outcomes of the developed deprescribing service for terminal cancer patients in CB-PCT. (3) Methods: A retrospective analysis compared the active care (AC) group to the historical usual care (UC) group. The clinical outcomes included the deprescribing rate of preventive medications, the proportion of patients with one or more medication-related problems (MRPs) resolved upon discharge, and the clinical significance. The implementability of the service was also gauged by the acceptance rates of pharmacists’ interventions. (4) Results: Preventive medications included lipid-lowering agents, gastroprotective agents, vitamins, antihypertensives, and antidiabetic agents. The AC group revealed a higher deprescribing rate (10.4% in the UC group vs. 29.6% in the AC group, p < 0.001). At discharge, more AC patients had one or more MRPs deprescribed (39.7% vs. 2.97% in UC, p < 0.001). The clinical significance consistently had a very significant rating (mean score of 2.96 out of 4). Acceptance rates were notably higher in the AC group (30.0% vs. 78.0%. p = 0.003). (5) Conclusions: The collaborative deprescribing service in CB-PCT effectively identified and deprescribed MRPs that are clinically significant and implementable in practice.

Is pain a main influence for various spiritual needs of patients with terminal cancer?: a multicenter cross-sectional study in southern China

“…Patients with terminal cancer have a life expectancy of less than 6 months and often face many comorbidities and systemic symptoms (Ko et al, 2023). Pain is one of the most common and intractable symptoms of terminal cancer, with an incidence rate of 66.4% (Yang et al, 2021).…”

Trends and Status of Hospice Use in South Korea (2018-2022)

“…Previous literature has also revealed that the introduction of home services was associated an increase in the number of cancer patients dying in their homes, suggesting an escalation in the use of home services among terminally ill cancer patients[17]. Regarding consultation-based care, considering that this service delivers hospice care to patients who prefer not to be admitted to a hospital ward or are waiting admission, its increasing utilization reflects its potentially significant role in the provision of hospice services in healthcare facilities without a hospice ward or in serving as a bridge to facilitate access to inpatient care[18]. The fact that the number of patients who used both inpatient and consultation-based services showed an escalating trend during the study period reinforces the role of consultation-based services in transferring patients to inpatient care, suggesting the need to prepare for the potentially growing demand for consultation-based care in the future.…”