Introduction of pharmaceutical expertise in a palliative care team in Sweden
- 228 Downloads
- 8 Citations
Abstract
Objective This paper presents for the first time the inclusion of dispensing pharmacists, a special group of pharmacy professionals, in a Swedish palliative care team. It also presents the drug stock management in the medication room of the clinical area and the improvement of drug logistics. In addition to a dispensing pharmacist, a pharmacist was included in this part of the project as well. Setting The palliative care team at ASIH Långbro Park, Sweden. Method The intervention with the dispensing pharmacists as new members of the interdisciplinary palliative team was evaluated by a questionnaire to the staff. An inventory of the different drugs in stock was performed in March 2006 and in April 2007, respectively. The inventory turnover rate was determined and the drug consumption for the last 6 months of 2005 and 2006, respectively, was also analysed. Main outcome measures The questionnaire used rating scales allowing participants to rate the questions/statements. The number of different drugs and drug packages in stock were recorded during the inventories. Drug costs were calculated and the inventory turnover rate was determined by dividing the annual cost of drugs by the value of the inventory. Drug consumption was analysed using the Xplain statistical programme, a statistical tool from Apoteket AB. Results The overall impression of the dispensing pharmacists was positive. The staff reported advantages in having a dispensing pharmacist present at ASIH not only for the drug logistics, but also for drug-related queries. The inventory of the drug stock and the drug-handling process resulted in a 14% reduction of product numbers and a 36% reduction in the tied-up capital for drugs in stock. The inventory turnover rate increased from 6.7 to 9.5. A 7% reduction of medication costs was also observed when comparing the last 6 months of 2006 with the costs in 2005. Conclusion The principal result of this project is that inclusion of pharmaceutical expertise on a palliative care team can be a valuable asset for the team in pharmaceutical issues and of great benefit for stock management, including cost savings and improvement of drug logistics.
Keywords
Attitude of health personnel Drug costs Drug storage Interprofessional relations Nurse’s role Palliative care Patient care team Pharmacists SwedenNotes
Acknowledgments
The authors gratefully acknowledge the co-operation of the staff at ASIH Långbro Park and at the hospital pharmacy at Karolinska University Hospital, Huddinge, Stockholm. Furthermore, the authors thank Louis Cuccia for valuable linguistic advice.
Funding
The authors thank the Swedish Cancer Society, ASIH Långbro Park and Apoteket AB for financial support.
Conflicts of interest
None.
References
- 1.American Society of Health-System Pharmacists. ASHP statement on the pharmacist’s role in hospice and palliative care. Am J Health Syst Pharm. 2002;59:1770–3.Google Scholar
- 2.Gilbar P, Stefaniuk K. The role of the pharmacist in palliative care: results of a survey conducted in Australia and Canada. J Palliat Care. 2002;18:287–92.PubMedGoogle Scholar
- 3.Hill RR. Clinical pharmacy services in a home-based palliative care program. Am J Health Syst Pharm. 2007;64:806, 808, 810.Google Scholar
- 4.Billings JA, Pantilat S. Survey of palliative care programs in United States teaching hospitals. J Palliat Med. 2001;4:309–14.CrossRefPubMedGoogle Scholar
- 5.Bremberg ER, Hising C, Nylen U, Ehrsson H, Eksborg S. An evaluation of pharmacist contribution to an oncology ward in a Swedish hospital. J Oncol Pharm Pract. 2006;12:75–81.CrossRefPubMedGoogle Scholar
- 6.Gillespie U, Alassaad A, Henrohn D, Garmo H, Hammarlund-Udenaes M, Toss H, et al. A comprehensive pharmacist intervention to reduce morbidity in patients 80 years or older: a randomized controlled trial. Arch Intern Med. 2009;169:894–900.CrossRefPubMedGoogle Scholar
- 7.Midlöv P, Bondesson A, Eriksson T, Petersson J, Minthon L, Höglund P. Descriptive study and pharmacotherapeutic intervention in patients with epilepsy or Parkinson’s disease at nursing homes in southern Sweden. Eur J Clin Pharmacol. 2002;57:903–10.CrossRefPubMedGoogle Scholar
- 8.Ahmedzai SH, Costa A, Blengini C, Bosch A, Sanz-Ortiz J, Ventafridda V, et al. A new international framework for palliative care. Eur J Cancer. 2004;40:2192–200.CrossRefPubMedGoogle Scholar
- 9.Addington-Hall J, Fakhoury W, McCarthy M. Specialist palliative care in nonmalignant disease. Palliat Med. 1998;12:417–27.CrossRefPubMedGoogle Scholar
- 10.WHO definition of palliative care. (cited 2009 October 16). http://www.who.int/cancer/palliative/definition/en/.
- 11.Force MV, Deering L, Hubbe J, Andersen M, Hagemann B, Cooper-Hahn M, et al. Effective strategies to increase reporting of medication errors in hospitals. J Nurs Adm. 2006;36:34–41.CrossRefPubMedGoogle Scholar
- 12.Leape LL, Kabcenell AI, Gandhi TK, Carver P, Nolan TW, Berwick DM. Reducing adverse drug events: lessons from a breakthrough series collaborative. Jt Comm J Qual Improv. 2000;26:321–31.PubMedGoogle Scholar
- 13.Guchelaar HJ, Colen HB, Kalmeijer MD, Hudson PT, Teepe-Twiss IM. Medication errors: hospital pharmacist perspective. Drugs. 2005;65:1735–46.CrossRefPubMedGoogle Scholar
- 14.McCarter TG, Centafont R, Daly FN, Kokoricha T, Leander Po JZ. Reducing medication errors: a regional approach for hospitals. Drug Saf. 2003;26:937–50.CrossRefPubMedGoogle Scholar
- 15.Martini S. About the environment and pharmaceuticals. 2008. Cited 2009 October 16. http://www.janusinfo.org/imcms/servlet/GetDoc?meta_id=7236.
- 16.Kendall S, Deacon-Crouch M, Raymond K. Nurses’ attitudes toward their role in patient discharge medication education and toward collaboration with hospital pharmacists: a staff development issue. J Nurses Staff Dev. 2007;23:173–9.CrossRefPubMedGoogle Scholar
- 17.Gerdemann A, Griese N, Schulz M. Pharmacy interns on the ward—a pilot study. Pharm World Sci. 2007;29:34–8.CrossRefPubMedGoogle Scholar
- 18.Gilbert L. Pharmacist and nurse: a team approach towards primary health care or a convenient “therapeutic alliance”? Int J Nurs Stud. 1997;34:367–74.CrossRefPubMedGoogle Scholar
- 19.Thompson DF, Kaczmarek ER, Hutchinson RA. Attitudes of pharmacists and nurses toward interprofessional relations and decentralized pharmaceutical services. Am J Hosp Pharm. 1988;45:345–51.PubMedGoogle Scholar
- 20.Gadri A, Pichon R, Zelger GL. A qualitative systemic analysis of drug dispensing in Swiss hospital wards. Pharm World Sci. 2008;30:343–52.CrossRefPubMedGoogle Scholar
- 21.Litzinger A, Rohde-Boehler R. Patient-oriented pharmacy on a special ward: results of a pilot project in Germany. Pharm World Sci. 1997;19:101–4.CrossRefPubMedGoogle Scholar
- 22.Hug BL, Jordan M, Plagge H, Schneider K, Surber C. Individualising drug dispensaries in a university hospital. Swiss Med Wkly. 2007;137:62–5.PubMedGoogle Scholar