A qualitative study to describe patient‐specific factors that relate to clinical need for and potential to benefit from a medication management service in palliative care

Abstract

Background In 2011, an advanced practice role was introduced to a specialist regional palliative care service to support an expansion of the number of palliative care home medicines reviews. Aim To gain insight into which types of community‐based palliative care patients benefit from medication management services in order to guide local service development. Method Thematic analysis of a case series of medication reviews conducted by the palliative care pharmacist. Results Over a 12‐week period, 15 medication reviews were conducted and analysed. Four patient categories that related to a clinical need and potential to benefit from a medication review were identified: managing a chronic disease as well as cancer; experiencing ongoing generalised symptoms; having existing or anticipated problems with swallowing or digestion; and having a recognised falls risk. Most patients fit into more than one category. Conclusion There is significant opportunity for pharmacists to enhance the quality of life of palliative care patients through improved use of medicines; however, incorporating the existing home medicine review program does not appear to be the most appropriate method for achieving this due to the program design. Delivering best outcomes for palliative care patients requires models of care that support communication and collaboration across the entire healthcare team and facilitate trusting therapeutic relationships between pharmacists and patients. Integration of advanced generalist pharmacists into clinical care teams is a positive step toward improving patient outcomes in palliative care.

The effectiveness of community-based palliative care programme components: a systematic review

“…Another study found positive family caregiver experiences with a 24/7 nursing care component of a rural programme [ 56 ]. Last, a study reported the potential to improve swallowing and digestion issues as well as reduced falls by including a medication management system within a programme [ 57 ].…”