Pharmacist’s role in the system of palliative and hospice care in Ukraine and Poland

Abstract

Introduction. The efficient pharmacotherapy is an important part of palliative and hospice care, and requires a multidisciplinary approach to the patients. The pharmacist, as the member of the multidisciplinary therapeutic team, is responsible for performing pharmaceutical care, which provides safe and efficient treatment. The aim of the research was to conduct a comparative research about the status of palliative and hospice care and role of the pharmacist (clinical pharmacist) in Ukraine and Poland.Material and methods. It was a questionnaire survey conducted in Ukraine, as well as analysis of information sources associated with this subject. The questionnaire was developed on the basis of similar study conducted in Poland. It consisted of 15 multiple-choice questions addressed to head physicians and doctors in Ukraine. The obtained results were compared to the results of the mentioned above Polish study. Results. Eight head physicians and 22 doctors (30 questionnaires) from 13 palliative and hospice care institutions in Ukraine responded to the survey. It has been found that almost half in Ukraine (43%) believed that the pharmacist should be a mandatory member of a multidisciplinary team, because of his/her significant role in drug management in hospice. Conclusion. A multidisciplinary approach to satisfying of patients' needs in palliative and hospice care has a great significance. Results of the study testify to the importance of including the pharmacists into the multidisciplinary team.

A national survey of hospice pharmacists and a comparison with international models

“…A survey of Polish hospices found that HPhs provided regular medicines advice to the MDT and organised medicines supply (in most of the 57% of hospices which had pharmacist input) although there was very little patient contact 12 . A similar study in Ukraine found that there was no current role for HPhs within the palliative care team although many doctors thought that there should be 13 . A multi-centre survey across Canada and Australia found that most hospices surveyed employed pharmacists and they were important members of the MDT with the most common duty reported as discharge medication review 14 .…”

Understanding the role of hospice pharmacists: a qualitative study

“…HPs had often developed methods of regular and ad-hoc communication with members of the MDT (depending on how much time they had) to pass-on or receive relevant information. The provision of information to the MDT was found to be commonplace as has been found elsewhere [16][17][18][19]. Lack of full access to patient records leads to time wasted piecing together information from different sources.…”

“…Challenges were shown in communication, knowledge, sourcing medicines and general time pressures with most HPs working part-time. This is the first study to qualitatively explore the role of a HP, although some surveys have been conducted concerning duties, hours and MDT working [ 6 , 17 – 19 ]. Our main findings concur with a previous study in 1995 of HPs performing administrative, clinical, educational and supply however the role of the pharmacist now encompasses much more in terms of clinical duties than was expected 25 years ago [ 25 ].…”

“…In Canada and Australia however, pharmacists conduct medication review within the hospice and Canadian pharmacists routinely provide patient consultations focused on pain and symptom management [18]. In Canada, multidisciplinary team (MDT) working was common in the form of ward rounds and team meetings but less so in Australia and England with MDT working rare in Poland [6,[17][18][19]. All surveys where pharmacists were working in hospices, showed provision of information for the rest of the MDT was a common duty and administrative duties such as medicine sourcing and supply were common in the UK and Poland although less commonplace in Canada and Australia [6,17,18].…”

“…A number of surveys have indicated levels of hospice provision around the world but the HP role is yet to be explored [6,[17][18][19]. American guidelines on the essential and desirable activities of hospice pharmacists were published in 2016 but it is unclear whether these have been adopted into practice locally or worldwide [20].…”