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

• Published in: BMC palliative care Vol. 23; no. 1; pp. 172 - 10
• Main Authors: M Chess-Williams, Lorna, M Broadbent, Andrew, Hattingh, Laetitia
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 16.07.2024; BioMed Central; BMC
• Subjects: Aged; Aged, 80 and over; Caregivers; Clinical outcomes; Collaboration; COVID-19; Cross-Sectional Studies; Deprescribing; Drug stores; Female; Health services; Hospitals; Humans; Male; Medical records; Medication management; Medication Therapy Management - standards; Middle Aged; Palliative care; Palliative Care - methods; Palliative Care - standards; Palliative medicine; Palliative treatment; Patient satisfaction; Pharmacists; Pharmacy; Polypharmacy; Practice; Reconciliation; Symptom management; Technology application; Telehealth; Telemedicine; Telemedicine - standards; Australia; Queensland Australia; United Kingdom > UK; United States > US; Palliative medicine; Polypharmacy; Telehealth; Deprescribing; Pharmacy; Medication management
• ISSN: 1472-684X; 1472-684X
• DOI: 10.1186/s12904-024-01508-1

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. 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. 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. 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.