Abstract

Background: In 2011, an advanced practice role was introduced to a specialist regional palliative care service in Australia to support an expansion of the number of palliative care home medicines reviews. Objectives: To gain insight into which types of community-based palliative care patients benefit from medication management services in order to guide local service development. Methods: Thematic analysis of a case series of medication reviews conducted by the palliative care pharmacist. Results: Over a 12-week period, 15 medication reviews were conducted and analysed. Four patient categories that related to a clinical need and potential to benefit from a medication review were identified: managing a chronic disease as well as cancer; experiencing ongoing generalised symptoms; having existing or anticipated problems with swallowing or digestion; and having a recognised falls risk. Most patients fit into more than one category. Conclusions: There is significant opportunity for pharmacists to enhance the quality of life of palliative care patients through improved use of medicines; however, incorporating the existing home medicine review program does not appear to be the most appropriate method for achieving this due to the program design. Delivering best outcomes for palliative care patients requires models of care that support communication and collaboration across the entire healthcare team and facilitate trusting therapeutic relationships between pharmacists and patients. Integration of advanced generalist pharmacists into clinical care teams is a positive step toward improving patient outcomes in palliative care.