By Tim Ho, PharmD; Lee Brune, PharmD Candidate; and Cassy Collins, PharmD Candidate, Illinois CancerCare
According to the World Health Organization, palliative care is defined as “an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness through the prevention and relief of suffering by early identification, assessment, and treatment of physical, psychosocial, and spiritual problems.” The goal of palliative care is to prevent and treat the symptoms and side effects of the illness and its corresponding treatment as early as possible. An article published in the New England Journal of Medicine found that early palliative care in lung cancer patients led to significant improvements in quality of life and mood. They also determined that these patients had less aggressive care at the end of life in addition to longer survival in comparison to standard care.
Palliative care is applicable for patients of any age and at any stage of disease, regardless of prognosis or life expectancy. Palliative care is often associated and confused with hospice care. While they share some similarities, they individually are quite different. Hospice care is intended for patients whose treatment is no longer controlling their illness and who have an estimated life expectancy of six months or less. In contrast, palliative care is given in addition to their treatment plan and can be started as soon as a patient is diagnosed in order to maintain the best possible quality of life.
The term palliative care describes a multidisciplinary team-based approach to the management of symptoms and treatment of possible side effects that may reduce a patient’s quality of life. This team may include, but is not limited to, physicians, dieticians, licensed clinical professional counsellors, nurses, pharmacists, and social workers. As patients work through their illness, the palliative care team has been expertly trained to provide comprehensive care to assist patients, family members, and caregivers.
Pharmacist’s Roles in Palliative Care
Pharmacists play a vital role in pharmacovigilance, which is the detection, assessment, and understanding of adverse effects caused by medications. Often, complex illnesses require specialized therapy and medication that may lead to patients experiencing adverse effects more frequently. Fortunately, pharmacists possess a unique clinical skill set to help identify medication interactions, which can aide in reducing any undesired effects. A study published in the Annals of Oncology found that 58 percent of cancer patients had at least one potential medication interaction. Of those, 34 percent were considered a major medication interaction that required an intervention. As a result, pharmacists are ideal members of a palliative care team, contributing by:
- Reviewing and assessing the appropriateness of medication orders and dosing strategies
- Identifying medication interactions and recommending an alternative
- Effectively educating and communicating with the palliative care team about medication therapy
- Counseling patients, family members, and caregivers to ensure they understand and follow the directions provided with medications
- Discussing the use of over-the-counter medications and herbal products
- Addressing and assisting with any financial or affordability concerns
- Ensuring safe and legal disposal of medications
Pharmacists can assist in optimizing the medications used to treat pain, nausea, vomiting, constipation, appetite, skin health, difficulty sleeping, fatigue, shortness of breath, and many other symptoms. They consider the patients’ goals of treatment, their beliefs, and affordability of therapy to recommend the safest and most effective medication options. The inclusion of a pharmacist improves the medication-related knowledge and skills of the palliative care team, which can ultimately lead to better patient medication management and quality of life.
Resources Available
There are many resources available for patients and their family members who are interested in learning more or pursuing palliative care treatment. To learn more about palliative care, visit www.getpalliativecare.org or www.caringinfo.org. Both resources have additional information and tools to help with decision making along with a database to find palliative care providers in your area. If you or a family member is interested in palliative care services, simply speak with your physician to determine if palliative care is right for you.
For more information, contact Illinois CancerCare. Visit www.illinoiscancercare.com, or call 309-243-3000. Illinois CancerCare is conveniently located at 8940 N. Wood Sage Rd. in Peoria.
Sources upon request.
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