PDF(Pubmed)
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.
METHODS: 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.
CONCLUSIONS: 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.
METHODS: 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.
CONCLUSIONS: 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.
摘要：
背景：接受姑息治疗的患者通常采用复杂的药物治疗方案来控制其症状和合并症，并面临药物相关问题的高风险。这项横断面研究的目的是评估药剂师对现有社区专家姑息治疗远程医疗服务对患者药物管理的参与。
方法：在6个月期间（2020年10月至2021年3月），专业姑息治疗药剂师每周参加两次姑息治疗远程健康会议。出席人数是根据收到的资金分配的。从药物管理审查中收集的数据包括多重用药的患病率，根据预期寿命有限的脆弱成年人的老年人处方筛查工具（STOPP/FRAIL）和处方建议，不适当药物的数量，症状控制和药物管理。
结果：共有95名患者参加了远程医疗服务，平均年龄为75.2岁（SD10.67）。虽然81例（85.3%）患者诊断为癌症，14例（14.7%）诊断为非癌症。在转诊时，84（88.4%，SD4.57）患者服用≥5种药物，其中51种（53.7%，SD5.03）服用≥10种药物。根据STOPP/FRAIL标准，54名（56.8%）患者服用了142种可能不适当的药物，平均每人2.6（SD1.16）次不适当药物。总的来说,从药物管理审查中接受了142项建议，其中49项（34.5％）与取消处方有关，20（14.0%）与药物相关的问题，症状管理35例（24.7%），药物管理38例（26.8%）。
结论：这项研究提供了有关在姑息治疗远程医疗服务中包括药剂师的价值的证据。药剂师的投入改善了社区姑息治疗患者的症状管理及其整体药物管理。
方法：在6个月期间（2020年10月至2021年3月），专业姑息治疗药剂师每周参加两次姑息治疗远程健康会议。出席人数是根据收到的资金分配的。从药物管理审查中收集的数据包括多重用药的患病率，根据预期寿命有限的脆弱成年人的老年人处方筛查工具（STOPP/FRAIL）和处方建议，不适当药物的数量，症状控制和药物管理。
结果：共有95名患者参加了远程医疗服务，平均年龄为75.2岁（SD10.67）。虽然81例（85.3%）患者诊断为癌症，14例（14.7%）诊断为非癌症。在转诊时，84（88.4%，SD4.57）患者服用≥5种药物，其中51种（53.7%，SD5.03）服用≥10种药物。根据STOPP/FRAIL标准，54名（56.8%）患者服用了142种可能不适当的药物，平均每人2.6（SD1.16）次不适当药物。总的来说,从药物管理审查中接受了142项建议，其中49项（34.5％）与取消处方有关，20（14.0%）与药物相关的问题，症状管理35例（24.7%），药物管理38例（26.8%）。
结论：这项研究提供了有关在姑息治疗远程医疗服务中包括药剂师的价值的证据。药剂师的投入改善了社区姑息治疗患者的症状管理及其整体药物管理。
