Cross-sectional study to evaluate patients' medication management with a new model of care: incorporating a pharmacist into a community specialist palliative care telehealth service.

IF 2.5 2区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Lorna M Chess-Williams, Andrew M Broadbent, Laetitia Hattingh
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Abstract

Background: Patients receiving palliative care are often on complex medication regimes to manage their symptoms and comorbidities and at high risk of medication-related problems. The aim of this cross-sectional study was to evaluate the involvement of a pharmacist to an existing community specialist palliative care telehealth service on patients' medication management.

Method: The specialist palliative care pharmacist attended two palliative care telehealth sessions per week over a six-month period (October 2020 to March 2021). Attendance was allocated based on funding received. Data collected from the medication management reviews included prevalence of polypharmacy, number of inappropriate medication according to the Screening Tool of Older Persons Prescriptions in Frail adults with limited life expectancy criteria (STOPP/FRAIL) and recommendations on deprescribing, symptom control and medication management.

Results: In total 95 patients participated in the pharmaceutical telehealth service with a mean age of 75.2 years (SD 10.67). Whilst 81 (85.3%) patients had a cancer diagnosis, 14 (14.7%) had a non-cancer diagnosis. At referral, 84 (88.4%, SD 4.57) patients were taking ≥ 5 medications with 51 (53.7%, SD 5.03) taking ≥ 10 medications. According to STOPP/FRAIL criteria, 142 potentially inappropriate medications were taken by 54 (56.8%) patients, with a mean of 2.6 (SD 1.16) inappropriate medications per person. Overall, 142 recommendations were accepted from the pharmaceutical medication management review including 49 (34.5%) related to deprescribing, 20 (14.0%) to medication-related problems, 35 (24.7%) to symptom management and 38 (26.8%) to medication administration.

Conclusion: This study provided evidence regarding the value of including a pharmacist in palliative care telehealth services. Input from the pharmacist resulted in improved symptom management of community palliative care patients and their overall medication management.

横断面研究,评估患者在新护理模式下的用药管理:将药剂师纳入社区专科姑息关怀远程医疗服务。
背景:接受姑息关怀治疗的患者通常需要服用复杂的药物来控制症状和并发症,并且极有可能出现与药物相关的问题。这项横断面研究旨在评估药剂师参与现有社区姑息关怀专科远程医疗服务对患者用药管理的影响:在为期六个月的时间内(2020 年 10 月至 2021 年 3 月),姑息关怀专科药剂师每周参加两次姑息关怀远程医疗会议。出席会议的时间根据所获资金分配。从药物管理审查中收集的数据包括多药滥用的发生率、根据《预期寿命有限的体弱成人中老年人处方筛选工具》(STOPP/FRAIL)得出的不适当药物的数量,以及关于去处方化、症状控制和药物管理的建议:共有 95 名患者参与了药品远程保健服务,平均年龄为 75.2 岁(标准差 10.67)。81名患者(85.3%)确诊为癌症,14名患者(14.7%)确诊为非癌症。在转诊时,84 名(88.4%,SD 4.57)患者服用的药物≥ 5 种,51 名(53.7%,SD 5.03)患者服用的药物≥ 10 种。根据 STOPP/FRAIL 标准,54 名(56.8%)患者服用了 142 种潜在的不适当药物,平均每人服用 2.6 种(标清 1.16)不适当药物。总体而言,142 项药物管理审查建议被采纳,其中 49 项(34.5%)与取消处方有关,20 项(14.0%)与药物相关问题有关,35 项(24.7%)与症状管理有关,38 项(26.8%)与药物管理有关:这项研究为在姑息关怀远程医疗服务中加入药剂师的价值提供了证据。药剂师的参与改善了社区姑息关怀患者的症状管理和整体用药管理。
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来源期刊
BMC Palliative Care
BMC Palliative Care HEALTH CARE SCIENCES & SERVICES-
CiteScore
4.60
自引率
9.70%
发文量
201
审稿时长
21 weeks
期刊介绍: BMC Palliative Care is an open access journal publishing original peer-reviewed research articles in the clinical, scientific, ethical and policy issues, local and international, regarding all aspects of hospice and palliative care for the dying and for those with profound suffering related to chronic illness.
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