Patterns of Palliative Care Pharmacist Interventions and Outcomes as Part of Inpatient Palliative Care Consult Service

Atayee, Rabia S.; Sam, Andrew M; Edmonds, Kyle P

doi:10.1089/jpm.2018.0093

Cited by 36 publications

(41 citation statements)

References 35 publications

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“…Length of hospital stay is a clinical outcome measurement used to represent efficiency in health care. Atayee et al () evaluated the impact of pharmacist involvement on patient hospital length of stay. However, they revealed that interventions made by the pharmacist did not lead to a decrease in length of stay.…”

Section: Discussionmentioning

confidence: 99%

“…A study evaluated the patient outcomes of a pharmacist‐led outpatient palliative care practice and demonstrated a statistically significant change in pain score for the third visit, but not for the second and fourth visits (Ma, Tran, Chan, Mitchell, & Atayee, ). Additionally, there are positive outcome studies evaluating the impact of pharmacists in a palliative care or pain management team for inpatients (Atayee, Sam, & Edmonds, ; Basri et al, ). In a retrospective study evaluating adult hospitalised patients, palliative care pharmacist saw 26.4% of the patient seen by the palliative care team, and hospital length of stay, length from admission to palliative care consult and time from consult to discharge or death were demonstrated significantly longer for patients seen by palliative care pharmacist in a palliative team (Atayee et al, ).…”

Section: Introductionmentioning

confidence: 99%

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Multidisciplinary intervention incorporating pharmacists in management of opioid‐naïve patients with moderate to severe cancer pain

et al. 2020

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Objective This study aims to investigate the impact of intervention of multidisciplinary team incorporating pharmacists for management of opioid‐naïve patients with moderate to severe cancer pain. Methods A retrospective cohort study was conducted to compare pre‐ and post‐multidisciplinary intervention groups in opioid‐naïve patients with moderate to severe cancer pain. Primary outcome was the proportions of appropriate pain assessment and opioid titration. Secondary outcomes were pain intensity (PI), length of hospital stay, opioid escalation index percentage (OEI%) and incidences of opioid‐related adverse events. Results A total of 400 patients were included in the study (pre‐intervention, n = 200; post‐intervention, n = 200). Continuous improvement in pain assessment and titration was recorded after intervention. Though no substantial differences existed between groups in PI on the day of discharge, post‐intervention group was associated with reduced length of hospital stay as well as decreased proportion of subjects with OEI% >5%. As for safety, significant decreases in constipation and vomiting were seen. Conclusion Findings suggest that interventions of multidisciplinary team incorporating pharmacists could improve cancer pain management for opioid‐naïve patients. Pharmacists should be considered as an important member of a multidisciplinary team in good pain management.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Multidisciplinary intervention incorporating pharmacists in management of opioid‐naïve patients with moderate to severe cancer pain

et al. 2020

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“…Two large studies investigating clinical patient populations, reported interventions in up to 95% and 81% of patients, respectively . Both these studies showed high intervention rates in pain management . Results from hospices also show pharmacists interventions can optimise patients’ treatments.…”

Section: Discussionmentioning

confidence: 99%

“…A second study in a specialised oncology clinic showed pharmacists’ interventions after implementation of a regular pharmacist in the team on drug‐interactions, duplicate therapies, management of side effects and untreated conditions . A third inpatient study identified an average of 3.5 pharmacist interventions per patient, with pain as the most common reason for consulting . The role of a pharmacist for ambulatory patients, who were still under the care of the hospital, has been studied in a small group of 11 patients, where 20 drug‐related problems were identified.…”

Section: Introductionmentioning

confidence: 99%

The oncology pharmacist as part of the palliative treatment team

Crul¹,

Oosterhof

2019

International Journal of Pharmacy Practice

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Objectives Patients who are no longer eligible for curative treatment often suffer from multiple complaints and require a multidisciplinary treatment approach. We incorporated two pharmacists in the palliative team, one hospital pharmacist and one pharmacist who were trained as a community pharmacist. The objective of our study was to evaluate their contribution to the palliative team. Methods During 13 months, the two pharmacists participated in all regular patient reviews and rounds and were available for individual consultation by all members of the palliative team on a daily basis. Each intervention (consults at request or during the patient rounds) was logged and categorised. Key findings During the study period, 115 patients were under the care of the palliative treatment team. The pharmacists were actively involved in 107 of these (93%). Pharmacists interventions occurred in 76% of patients, with an average of 1.5 interventions per patient. The most common intervention types were giving general therapeutic advice, starting of a drug for an uncontrolled symptom and stopping a drug that was given as prophylaxis. When comparing the contribution of the hospital pharmacist and the outpatient pharmacist, their interventions overlapped with regard to starting drugs, choice of drugs and side-effect management. However, interventions on parenteral drugs or optimising the route of administration mostly came from the hospital pharmacist, whereas the outpatient pharmacist more often intervened in increasing adherence and stopping drugs. Conclusion The palliative pharmacist team adds expertise to the palliative treatment team, with an active contribution in 76% of patients.

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“…The pharmacist's job inside palliative care groups is expanding and introductory great results have been accounted for. Investigation of patients with known date of first pharmacist visit found altogether enhanced LOS, LTC, and CTD for patients with early access to palliative pharmacy (notwithstanding alternate individuals from the palliative group) contrasted with those without early access [42]. Network drug stores are recommended to consider stocking the five "fundamental" palliative care drugs: clonazepam 1mg/ml, morphine 10mg/ml, haloperidol 5mg/ml, metoclopramide 10mg/2ml, and Hyoscine butylbromide 20mg/ml [43,44] Clinicians Involved in PPC Palliative care clinicians are also called to assist with pediatric-aged patients.…”

Section: Role Of the Caregiversmentioning

confidence: 99%