1 Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, California.
2 Department of Pharmacy, University of California, San Diego Health, La Jolla, California.
J Palliat Med. 2018 Dec;21(12):1761-1767. doi: 10.1089/jpm.2018.0093. Epub 2018 Jun 29.
Palliative care uses a team approach, including physicians, nurses, social workers, chaplains, and pharmacists. The pharmacist's role within palliative care teams is increasing and initial favorable outcomes have been reported.
This retrospective study evaluated adult hospitalized patients seen by a part-time palliative care specialist pharmacist as part of the palliative care consultation team at an academic health system during a 15-month period between September 1, 2015, and March 30, 2017. Our study's objective is to identify patterns of an inpatient palliative care pharmacist's interventions and outcomes and evaluate the impact of pharmacist involvement on patient hospital length of stay (LOS), length from admission to palliative care consult (LTC), and time from consult to discharge or death (CTD).
The palliative care pharmacist was on service 35% of the time and saw 26.4% of the patient seen by the palliative care team (n = 341 out of 1293). Each patient received an average of 3.5 interventions with an average of 4.1 documented outcomes. The most common interventions were optimizing palliative medication regimen and providing education; most common outcomes were implementation of a change in palliative medication regimen and education of healthcare professionals. Overall, patients seen by the palliative care pharmacist were younger (p < 0.05), more likely to be female (p < 0.05), and more likely to have a primary palliative consultation reason listed as "pain" (p < 0.005). LOS, LTC, and CTD were significantly longer for patients seen by palliative care pharmacist.
Pharmacist interventions and outcomes were predominantly related to optimizing symptoms by changes in medication regimen and education of healthcare professionals. A subanalysis of patients with known date of first pharmacist visit found significantly improved LOS, LTC, and CTD for patients with early access to palliative pharmacy (in addition to the other members of the palliative team) compared to those without early access.
姑息治疗采用团队方法，包括医生、护士、社会工作者、牧师和药剂师。药剂师在姑息治疗团队中的角色正在增加，并已报告了初步的有利结果。
这项回顾性研究评估了 2015 年 9 月 1 日至 2017 年 3 月 30 日期间，在一个学术健康系统中，一名兼职姑息治疗专家药剂师作为姑息治疗咨询团队的一部分，为住院的成年患者提供服务的情况。我们的研究目的是确定住院姑息治疗药剂师干预措施和结果的模式，并评估药剂师参与对患者住院时间（LOS）、从入院到姑息治疗咨询（LTC）的时间和从咨询到出院或死亡（CTD）的影响。
姑息治疗药剂师的服务时间为 35%，为姑息治疗团队治疗的 26.4%的患者（1293 名患者中有 341 名）提供服务。每位患者接受的平均干预措施为 3.5 次，平均记录的结果为 4.1 次。最常见的干预措施是优化姑息治疗药物治疗方案和提供教育；最常见的结果是改变姑息治疗药物治疗方案和教育医疗保健专业人员。总体而言，接受姑息治疗药剂师治疗的患者更年轻（p<0.05）、更可能为女性（p<0.05）、更可能将主要姑息治疗咨询原因列为“疼痛”（p<0.005）。接受姑息治疗药剂师治疗的患者的 LOS、LTC 和 CTD 明显更长。
药剂师的干预措施和结果主要与通过改变药物治疗方案和教育医疗保健专业人员来优化症状有关。对已知首次接受药剂师访问日期的患者进行亚分析发现，与没有早期获得姑息治疗药物的患者相比，早期获得姑息治疗药物（除姑息治疗团队的其他成员外）的患者的 LOS、LTC 和 CTD 明显改善。
