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The Role of Pharmacists in Palliative and End of Life...
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The Role of Pharmacists in Palliative and End of Life Care

A special issue of Pharmacy (ISSN 2226-4787). This special issue belongs to the section "Pharmacy Practice and Practice-Based Research".

Deadline for manuscript submissions: closed (20 August 2022) | Viewed by 20921

Special Issue Editor

Dr. Eleanor Wilson

E-Mail Website
Guest Editor
1. School of Health Sciences, University of Nottingham, Nottingham, UK
2. Nottingham Centre for the Advancement of Research in End of life care(NCARE), B302 School of Health Sciences, Medical School, Queen’s medical centre, University of Nottingham, Nottingham NG7 2UH, UK
Interests: Huntington's disease; MND; neurological conditions; long-term conditions; medications management; community nursing; delivering end of life care in the home; support for carers; anticipatory prescribing; end of life care in care homes; medicines management

Special Issue Information

Dear Colleagues,

As healthcare improves and technologies develop, people with terminal illness are increasingly likely to be cared for, and die, at home. However, there are considerable inequalities in access to medication and palliative care across the globe and within higher income countries such as the UK. Towards the end of life, the numbers of medications prescribed can increase, and regimes become more complex. These often include powerful painkillers and medications that can have serious side effects. As they become increasingly unwell, patients may require frequent and irregular changes to medication regimes and need considerable support, often from family members, in order to cope with the management of medications. Yet failure to take medications correctly, and unmanaged symptoms, can result in crises and unplanned hospital admissions. The understanding of the role of pharmacists in palliative and end-of-life care remains limited. This Special Issues seeks to explore pharmacist’s contributions to end-of-life care in both the home and hospital environments.

This Special Issue of Pharmacy is looking for contributions from researchers from all over the world, with the aim of exploring a number of issues around the pharmacy in palliative and end-of-life care, such as:

  • the views of patients, family member or pharmacists;
  • the role of pharmacists in community/hospital palliative and end-of-life care;
  • if and how pharmacists are integrated into palliative care teams;
  • the management of medications at the end of life in the home environment;
  • types and quantities of medications used at the end of life;
  • access to medication at the end of life;
  • use of “anticipatory” or “just in case” medications;
  • the contribution of pharmacists to hospital discharge;
  • navigation of primary and secondary care;
  • the role for pharmacists after the death

Contributions can be in the form of reviews or original research papers. We also welcome case studies and insightful commentaries.

Dr. Eleanor Wilson
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Pharmacy is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • medication management
  • pharmacotherapy
  • treatment compliance
  • palliative care
  • end-of-life care
  • home care
  • “just in case” medication
  • anticipatory medication
  • deprescribing

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Published Papers (6 papers)

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Editorial

Jump to: Research, Other

2 pages, 158 KiB  
Editorial
Preface: The Role of Pharmacists in Palliative and End of Life Care
by Eleanor Wilson
Pharmacy 2021, 9(3), 139; https://doi.org/10.3390/pharmacy9030139 - 17 Aug 2021
Cited by 1 | Viewed by 3126
Abstract
In this Special Issue exploring the role of pharmacists in palliative and end of life care, we sought articles that would shed light on the ways in which pharmacists could impact end of life care [...] Full article
(This article belongs to the Special Issue The Role of Pharmacists in Palliative and End of Life Care)

Research

Jump to: Editorial, Other

8 pages, 236 KiB  
Article
The Impact of an Electronic Prescribing Template with Decision Support upon the Prescribing of Subcutaneous Infusions at the End of Life in a Community Setting: A Future Vision for Community Palliative Care
by Y. K. Au, L. Baker and J. Hindmarsh
Pharmacy 2022, 10(5), 112; https://doi.org/10.3390/pharmacy10050112 - 9 Sep 2022
Cited by 2 | Viewed by 2377
Abstract
Objectives: To assess the impact of an electronic prescribing template with decision support upon the frequency of prescription errors, guideline adherence (relating to dose ranges), and prescription legality when prescribing continuous subcutaneous infusions (CSCI) in a palliative demographic. Design, setting, and participants: [...] Read more.
Objectives: To assess the impact of an electronic prescribing template with decision support upon the frequency of prescription errors, guideline adherence (relating to dose ranges), and prescription legality when prescribing continuous subcutaneous infusions (CSCI) in a palliative demographic. Design, setting, and participants: Before-and-after study across a large UK city utilizing local prescribing data taken from patients receiving end-of-life care. Intervention: An electronic prescribing template with decision support. Main outcome measures: The following were assessed: (1) the rate of prescription errors; (2) the proportion of prescriptions specifying a dose range and if the specified range complied with local recommendations; and (3) the proportion of prescriptions specifying legal mixing directions. Results: The intervention was associated with a significant reduction in errors of omission, with all prescriptions clearly stating drug indication, route of administration, drug dose, and infusion duration. The numbers of continuous subcutaneous infusion prescriptions that specified dose ranges were similar at baseline and post-intervention, at 71% (n = 122) and 72% (n = 179), respectively. At baseline, 69% (n = 84) of CSCI prescriptions specifying a dose range were deemed safe, and post-intervention, 97% (n = 173) were determined to be safe. At baseline, mixing directions were not specified correctly on any continuous subcutaneous infusion prescriptions, while post-intervention, such directions were correct on 75% (n = 157; p < 0.05) of the prescriptions. Conclusions: The intervention eliminated errors of omission, ensured the safety of prescribed dose ranges, and improved compliance with legislation surrounding the mixing of multicomponent infusions. Overall, the intervention has the potential to improve patient safety at the end of life and to increase the efficiency of community services. Full article
(This article belongs to the Special Issue The Role of Pharmacists in Palliative and End of Life Care)
9 pages, 207 KiB  
Article
The Development of an Enhanced Palliative Care Pharmacy Service during the Initial COVID-19 Surge
by Jaquie Hanley, Maureen Spargo, Joanne Brown and Julie Magee
Pharmacy 2021, 9(4), 196; https://doi.org/10.3390/pharmacy9040196 - 9 Dec 2021
Cited by 3 | Viewed by 3300
Abstract
The Northern Health and Social Care Trust developed an enhanced palliative care pharmacy service for acute inpatients within a large hospital in Northern Ireland during the initial COVID-19 surge. By training additional staff, there was an opportunity to increase service provision, utilising palliative [...] Read more.
The Northern Health and Social Care Trust developed an enhanced palliative care pharmacy service for acute inpatients within a large hospital in Northern Ireland during the initial COVID-19 surge. By training additional staff, there was an opportunity to increase service provision, utilising palliative care pharmacy skills to undertake activities such as the symptom management of patients, appropriate management of medicines, improved access to medicines, advice for other healthcare professionals, and supporting discharge from the hospital. The data collected showed a mean of 6.8 interventions per patient, and that, irrespective of the demand resulting from the COVID-19 pandemic, the palliative care pharmacy team had a role in improving the quality of care for palliative and end-of-life patients. Subsequent data analysis also demonstrated associated cost saving and the potential for the palliative care pharmacy team to reduce the length of stay at the hospital. Full article
(This article belongs to the Special Issue The Role of Pharmacists in Palliative and End of Life Care)

Other

Jump to: Editorial, Research

6 pages, 219 KiB  
Case Report
End-of-Life and Palliative Care in a Critical Care Setting: The Crucial Role of the Critical Care Pharmacist
by Rhona Sloss, Reena Mehta and Victoria Metaxa
Pharmacy 2022, 10(5), 107; https://doi.org/10.3390/pharmacy10050107 - 31 Aug 2022
Cited by 1 | Viewed by 2371
Abstract
Critical care pharmacists play an important role in ICU patient care, with evidence showing reductions in drug prescribing errors, adverse drug events and costs, as well as improvement in clinical outcomes, such as mortality and length of ICU stay. Caring for critically ill [...] Read more.
Critical care pharmacists play an important role in ICU patient care, with evidence showing reductions in drug prescribing errors, adverse drug events and costs, as well as improvement in clinical outcomes, such as mortality and length of ICU stay. Caring for critically ill patients around the end of their life is complicated by the acute onset of their illness and the fact that most of them are unable to communicate any distressing symptoms. Critical care pharmacists are an integral part of the ICU team during a patient’s end-of-life care and their multifaceted role includes clinical support for bedside staff, education, and training, as well as assistance with equipment and logistics. In this article, we highlight the important role of the ICU pharmacist using a ‘real-life’ clinical case from our hospital. Full article
(This article belongs to the Special Issue The Role of Pharmacists in Palliative and End of Life Care)
6 pages, 198 KiB  
Opinion
Palliative Care: A Primary Care Pharmacist Perspective
by Julia Bognar
Pharmacy 2022, 10(4), 81; https://doi.org/10.3390/pharmacy10040081 - 13 Jul 2022
Cited by 2 | Viewed by 2333
Abstract
The overview approaches pharmacy practice in palliative care from a global viewpoint and aims to provide insight into front-line pharmacist–patient relationships by sharing case studies and personal experiences. Full article
(This article belongs to the Special Issue The Role of Pharmacists in Palliative and End of Life Care)
11 pages, 688 KiB  
Commentary
Understanding the Potential for Pharmacy Expertise in Palliative Care: The Value of Stakeholder Engagement in a Theoretically Driven Mapping Process for Research
by Joseph Elyan, Sally-Anne Francis and Sarah Yardley
Pharmacy 2021, 9(4), 192; https://doi.org/10.3390/pharmacy9040192 - 26 Nov 2021
Cited by 5 | Viewed by 3673
Abstract
Potentially avoidable medication-related harm is an inherent risk in palliative care; medication management accounts for approximately 20% of reported serious incidents in England and Wales. Despite their expertise benefiting patient care, the routine contribution of pharmacists in addressing medication management failures is overlooked. [...] Read more.
Potentially avoidable medication-related harm is an inherent risk in palliative care; medication management accounts for approximately 20% of reported serious incidents in England and Wales. Despite their expertise benefiting patient care, the routine contribution of pharmacists in addressing medication management failures is overlooked. Internationally, specialist pharmacist support for palliative care services remains under-resourced. By understanding experienced practices (‘what happens in the real world’) in palliative care medication management, compared with intended processes (‘what happens on paper’), patient safety issues can be identified and addressed. This commentary demonstrates the value of stakeholder engagement and consultation work carried out to inform a scoping review and empirical study. Our overall goal is to improve medication safety in palliative care. Informal conversations were undertaken with carers and various specialist and non-specialist professionals, including pharmacists. Themes were mapped to five steps: decision-making, prescribing, monitoring and supply, use (administration), and stopping and disposal. A visual representation of stakeholders’ understanding of intended medicines processes was produced. This work has implications for our own and others’ research by highlighting where pharmacy expertise could have a significant additional impact. Evidence is needed to support best practice and implementation, particularly with regard to supporting carers in monitoring and accessing medication, and communication between health professionals across settings. Full article
(This article belongs to the Special Issue The Role of Pharmacists in Palliative and End of Life Care)
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