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

Abstract

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.

Pharmacists are initiators in palliative care for patients with rare diseases

“…Today community pharmacists [ 27 – 30 ], capable and trained to treat patients at a personal level, as well as hospital [ 31 – 34 ] pharmacists are quite late involved in palliative care management practiced for many centuries (Fig. 1 ).…”

Standard of practice in palliative care for pharmacy services

“…Pharmacists are essential to addressing and managing medicines-related issues, and educating and supporting patients and/or their carers. 38,39 Palliative care pharmacists, ideally embedded within palliative care interdisciplinary teams, demonstrate competence in palliative care and the ability to integrate medicines expertise with holistic care. Palliative care pharmacists who do not work in an embedded role (non-specialist palliative care settings) can be supported by being given access to advice from palliative care pharmacists and other members of palliative care interdisciplinary teams who do work in specialist palliative care settings.…”

Pharmacists’ clinical roles and activities in inpatient hospice and palliative care: a scoping review

“…A European whitepaper on standards and norms for HPC lists pharmacists as members of the multiprofessional team in the provision of PC services, yet fails to define their roles [ 25 ]. The COVID-19 situation contributed efforts to further develop the role of pharmacists in HPC [ 26 ] and pharmacy services in patients with advanced cancer are increasingly implemented [ 27 ]. However, the scope of HPC is much broader.…”