Atayee Rabia Samady, Best Brookie M, Daniels Charles E
Doris A. Howell Palliative Care ServiceUniversity of California, San DiegoSkaggs School of Pharmacy and Pharmaceutical Sciences, Jolla, CA 92093-0845, USA.
J Palliat Med. 2008 Oct;11(8):1077-82. doi: 10.1089/jpm.2008.0023.
The roles of a pharmacist in hospice and inpatient palliative care settings have been described. However, no reports of a palliative care pharmacist in an ambulatory care setting have been published. Our objective was to establish a model for incorporating an outpatient clinical pharmacist as part of a multidisciplinary palliative care team.
A palliative care pharmacist based out of a retail pharmacy was incorporated as part of a consultative ambulatory palliative care service (known as the Doris A. Howell Service) at the University of California, San Diego Moores Cancer Center. The pharmacist completed all legal requirements to prescribe under a collaborative practice agreement in California (including National Provider Identifier [NPI] and US Drug Enforcement Agency [DEA] US Drug Enforcement Agency (DEA) registration).
From November 2006 through August 2007, the palliative care pharmacist consulted 29 new patients (the average age of patients was 49; range, 20-78 years) who had 114 clinic visits. The most common reason for referral to the palliative care pharmacist was for pain management (27/29; 93%). During the 114 patient clinic visits, 98% (112/114) of the palliative care pharmacist medication recommendations were accepted by the primary care oncologist. Physicians completed a satisfaction survey and reported that the top three useful activities of the Howell Service were: additional time spent with patients without physician present (90.9%), pain and symptom management (81.8%), and psychosocial support (72.7%).
This is the first report of a palliative care pharmacist in a retail-based ambulatory care setting. Initial results demonstrate the success of this pilot program.
药剂师在临终关怀和住院姑息治疗环境中的作用已有描述。然而，尚无关于门诊姑息治疗中医师角色的报道。我们的目标是建立一个模式，将门诊临床药剂师纳入多学科姑息治疗团队。
一名驻零售药店的姑息治疗药剂师被纳入加利福尼亚大学圣地亚哥分校穆尔斯癌症中心的门诊姑息治疗咨询服务（即多丽丝·A·豪厄尔服务）。该药剂师完成了加利福尼亚州根据合作医疗协议开处方的所有法律要求（包括国家提供者识别码[NPI]和美国药品管理局[DEA]注册）。
从2006年11月到2007年8月，姑息治疗药剂师会诊了29名新患者（患者平均年龄为49岁；范围为20 - 78岁），这些患者共进行了114次门诊就诊。转诊给姑息治疗药剂师的最常见原因是疼痛管理（27/29；93%）。在114次患者门诊就诊期间，初级护理肿瘤学家接受了姑息治疗药剂师98%（112/114）的用药建议。医生完成了一项满意度调查，并报告豪厄尔服务最有用的三项活动是：在无医生在场的情况下与患者额外相处的时间（90.9%）、疼痛和症状管理（81.8%）以及心理社会支持（72.7%）。
这是关于零售药店门诊姑息治疗中医师角色的首次报道。初步结果证明了该试点项目的成功。
