The Need for Palliative Care in Pharmacy Education

Pruskowski, Jennifer; Patel, Ravi; Brazeau, Gayle A.

doi:10.5688/ajpe7410

Cited by 15 publications

(7 citation statements)

References 39 publications

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“…[8][9][10] Corresponding author: Katie F. Leslie, PhD, MS Associate Professor, Sullivan University College of Pharmacy and Health Sciences 2100 Gardiner Ln., Louisville, KY 40205, USA Phone: 502-777-1667; Email: kleslie@sullivan.edu Deprescribing has gained increased attention in health sciences education with multiple calls for added content within curricula emphasizing opportunities for interprofessional learning experiences. [11][12][13][14] Specific to academic pharmacy, there is significant need to enhance teaching of optimal prescribing and deprescribing related content with student assessment measures in the didactic and experiential curricula. 12,15 In addition to educational content and evaluations, there are needs for further research into pharmacists' impact on deprescribing in end-of-life care settings, and to assess the need for and sustainability of palliative and hospice care pharmacists.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of an Interprofessional Academic-Practice Partnership in End of Life Care

2021

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Introduction: The purpose of this mixed-methods study was to evaluate an interprofessional academic-practice partnership in end of life care by examining patient medication outcomes, the contributions of student pharmacists and a pharmacy preceptor to care teams, and student learning experiences. Methods: Retrospective chart review assessed polypharmacy differences in hospice patients with a primary terminal diagnosis of non-Alzheimer’s dementia between two patient groups; Group 1 managed on interprofessional care teams within the pharmacy partnership, and Group 2, managed on teams without a pharmacist. Team members who interacted with student pharmacists and the pharmacy preceptor participated in semi-structured key informant interviews to document perceptions of pharmacy contributions to care teams and the organization. At the end of their APPE, students completed reflective writings regarding their learning. Results: Patients in Group 1 were on statistically significant fewer medications than Group 2 at both week 4 and weeks 7-12 following admission. Five conceptual themes emerged from interviews: pharmacists as team medication experts, improved patient outcomes, interprofessional collaboration, patient/caregiver trust in medication regimens, and desire for sustainability. Student reflections included the following learning themes: teamwork, respect, value, and patient-centered care. Conclusions: The addition of a pharmacist on interprofessional care teams decreased the average number of medications in the non-Alzheimer’s end of life patient population. Team members identified value-added contributions of student pharmacists and the pharmacy preceptor that enhanced team efficiency and patient care. Student pharmacists recognized these contributions and the experience served as an exemplar of interprofessional practice.

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Section: Introductionmentioning

confidence: 99%

Evaluation of an Interprofessional Academic-Practice Partnership in End of Life Care

2021

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“…This multipronged approach for all students is novel and aligns with the need for palliative care education for all students, as recently highlighted in pharmacy education. This educational need mirrors the growing need for palliative care pharmacists and the diverse roles that pharmacists may play in this setting 19‐21 . The role of the palliative care pharmacist includes direct patient care, counseling, patient advocacy, and education 21 .…”

Section: Discussionmentioning

confidence: 97%

A multipronged approach to teaching end‐of‐life care to student pharmacists

Howard

Atanda

Gaviola

2021

J Am Coll Clin Pharm

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IntroductionStudent pharmacists are typically taught topics regarding end‐of‐life care through required didactic courses or professional electives. Important topics such as death and dying and empathetic communication skills surrounding difficult end‐of‐life care discussions are often unaddressed. To best equip students with the skills needed for practice, it is important to expose them to multiple aspects of end‐of‐life care.ObjectiveTo evaluate the impact of a coordinated multipronged teaching approach including a workshop‐based activity on student pharmacists' initial perceptions, knowledge, and confidence related to end‐of‐life care.MethodsWithin our curriculum, topics surrounding end‐of‐life care have historically focused on pharmacotherapy with minimal time spent on conversation practice and empathy development. In spring 2019, we conducted an all‐day session incorporating various teaching approaches (ie, didactic lecture, ethical debate, Death over Dinner workshop) to prepare students to engage in these difficult discussions. A 21‐item survey, administered at three time points (pre‐, mid‐, post‐), assessed student pharmacists across three domains: Perceptions, Confidence, and Knowledge surrounding end‐of‐life.ResultsNinety‐six students participated in the session with 91% completing the pre‐survey, 69% completing the midpoint, and 59% completing the post‐survey. Forty‐nine (51%) completed matched survey responses across all time points. There was significant improvement in 13 (62%) of the survey items across three domains: 43% of items related to perception, 43% knowledge, and 100% confidence.ConclusionsA multipronged, workshop‐based approach to teaching end‐of‐life care to facilitate difficult discussions surrounding death improved perceptions, confidence, and perceived knowledge among student pharmacists. This approach provided numerous avenues for students to learn and develop empathetic communication skills surrounding end‐of‐life care and represents an innovative approach to prepare students for conversations surrounding death and dying within their professional and personal lives.

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“…56 Pruskowski et al reported that only 1% of the total curriculum time for pharmacists offers palliative care and end-of-life education. 57 There is also a gap in postgraduate opportunities, since the number of pain and palliative care postgraduate programmes is limited. 57 Furthermore, Xue et al showed in their study that about 59% of pharmacists had less than one year of experience working with patients with cancer, although they were well acquainted with pharmacology of pain.…”

Section: Discussionmentioning

confidence: 99%

“…57 There is also a gap in postgraduate opportunities, since the number of pain and palliative care postgraduate programmes is limited. 57 Furthermore, Xue et al showed in their study that about 59% of pharmacists had less than one year of experience working with patients with cancer, although they were well acquainted with pharmacology of pain. 58 The educational model for pharmacists is not adequate to prepare them for this type of care, hence several authors have organized strategies to develop necessary knowledge to teach clinical pharmacists about palliative care and the care of diseases that accompany elderly.…”

Section: Challenges In This Fieldmentioning

confidence: 99%

Role of clinical pharmacist in the palliative care of adults and elderly patients with cancer: A scoping review

Franco

Souza

Lima

et al. 2022

J Oncol Pharm Pract

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Objective: We conducted this scoping review to map and summarize scientific evidence on the role of clinical pharmacists in the palliative care of adults and elderly patients with cancer. Data Sources: A literature search was performed in MEDLINE, PubMed Central, Embase, Web of Science, Scopus, and BVS/BIREME for studies published until November 22nd, 2020. Studies that reported work experiences adopted by clinical pharmacists in the palliative care of adults and elderly patients with cancer were included. Two independent authors performed study selection and data extraction. Any disagreements were resolved by discussion with the third and fourth authors. The pharmacist interventions identified in the included studies were described based on key domains in the DEPICT v.2. Data Summary: A total of 586 records were identified, of which 14 studies fully met the eligibility criteria. Most of them were conducted in the United States of America (n = 5) and Canada (n = 5) and described the workplace of the pharmacist in clinic/ambulatory (n = 10). Clinical pharmacists performed several activities and provided services, highlighting medication review (n = 12), patient and caregivers education (n = 12), medication histories and-or medication reconciliation (n = 6). The pharmacist interventions were mostly conducted for patients/caregivers (n = 13), by one-on-one contact (n = 14), and by face-to-face (n = 13). Pharmacists were responsible mainly for change or suggestion for change in therapy (n = 12) and patient counselling (n = 12). Pharmacist interventions were well accepted by the clinical team. Overall, studies showed that pharmacists, within an interdisciplinary team, had significant impacts on measured outcomes. Conclusions: In recent years, there have been advances in the role of the pharmacist in palliative care of patients with cancer and there are great opportunities in this field. They play an important role in managing cancer pain and other symptoms, as well as resolving drug related problems. We encourage more research to be carried out to strengthen this field and to benefit patients with advanced cancer with higher quality of life.

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The Need for Palliative Care in Pharmacy Education

Cited by 15 publications

References 39 publications

Evaluation of an Interprofessional Academic-Practice Partnership in End of Life Care

Evaluation of an Interprofessional Academic-Practice Partnership in End of Life Care

A multipronged approach to teaching end‐of‐life care to student pharmacists

Role of clinical pharmacist in the palliative care of adults and elderly patients with cancer: A scoping review

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