1 Pharmacy Department, Barwon Health, Geelong, VIC, Australia.
2 Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, VIC, Australia.
Palliat Med. 2018 Sep;32(8):1369-1377. doi: 10.1177/0269216318777390. Epub 2018 May 25.
Pharmacists have a key role to play in optimisation of medication regimens and promotion of medication safety. The role of specialist pharmacists as part of the multidisciplinary palliative care team, especially in the primary care setting, is not widely recognised.
To explore the perspectives of stakeholders about the gaps in the current model of community palliative care services in relation to medication management and to assess their opinions pertaining to the role of a specialist palliative care pharmacist in addressing some of those gaps.
Qualitative study utilising three focus groups involving 20 stakeholders. Thematic analysis was carried out using a framework approach and interpreted in the context of the Chronic Care Model for improving primary care for patients with chronic illness.
SETTING/PARTICIPANTS: Setting was a large regional Australian palliative care service. Participants included palliative care consumers and clinicians specifically patients, caregivers, physicians, nurses and pharmacists.
Five major themes emerged from the focus groups: access to resources, medicines and information; shared care; challenges of polypharmacy; informal caregiver needs and potential roles of a palliative care pharmacist. Gaps in access to medicines/resources, training for generalist practitioners, communication between treating teams and lack of support for patients and carers were cited as factors adversely impacting medication management in community-based palliative care.
While community-based palliative care is an essential aspect of meeting the health care demands of an ageing society, the current model has several gaps and limitations. An appropriately qualified and skilled pharmacist within the palliative care team may help to address some of the gaps in relation to medication access and appropriateness.
药剂师在优化药物治疗方案和促进药物安全方面发挥着关键作用。专科药剂师作为多学科姑息治疗团队的一部分，尤其是在初级保健环境中的作用尚未得到广泛认可。
探讨利益相关者对当前社区姑息治疗服务模式在药物管理方面存在的差距的看法，并评估他们对姑息治疗专科药剂师在解决其中一些差距方面的作用的看法。
采用涉及 20 名利益相关者的三个焦点小组的定性研究。使用框架方法进行主题分析，并在改善慢性病患者初级保健的慢性护理模型背景下进行解释。
地点/参与者：地点是澳大利亚一个大型地区姑息治疗服务机构。参与者包括姑息治疗的消费者和临床医生，特别是患者、护理人员、医生、护士和药剂师。
从焦点小组中出现了五个主要主题：资源、药物和信息的获取；共同护理；多药治疗的挑战；非正式护理人员的需求和姑息治疗药剂师的潜在角色。提到了在社区姑息治疗中获取药物/资源、普通医生培训、治疗团队之间的沟通以及对患者和护理人员的支持不足等方面存在差距，这些都对药物管理产生了不利影响。
虽然基于社区的姑息治疗是满足老龄化社会医疗保健需求的重要方面，但当前的模式存在一些差距和局限性。姑息治疗团队中具有适当资格和技能的药剂师可能有助于解决与药物获取和适当性相关的一些差距。
