Pharmaceutical care applied to the hospice setting: a cancer pain model

A review of the concept of pharmaceutical care applied to the hospice setting with emphasis on the management of cancer pain. Traditionally pharmacists involved in hospice care have acted in a distributive function and as an information resource. The advantages of having a hospice pharmacist practicing pharmaceutical care are many and include enhanced patient quality of care through monitoring patient outcomes, establishing drug therapy protocols, enhanced patient compliance through patient education, better pain and symptom control, and staff education. Monitoring therapeutic outcomes starts with chart reviews to collect all relevant information and attending patient care conferences to obtain information concerning the patient's condition. Once this is done, a patient-specific drug-related problem list is formulated, and from this list, desired therapeutic outcomes and alternatives are established to monitor therapy and to insure the drug is producing the desired effect. Pharmaceutical care fits well with the concept of hospice care, which has as its primary purpose maintaining the quality of life in the terminal patient. There is no portion of caring for the terminally ill patient that is more important than the management of pain. As a result of implementing the concept of pharmaceutical care in the hospice setting for cancer patients, pain can be managed in an effective and compassionate way. By monitoring treatments and eliminating medication-induced problems, the pharmacist becomes a valuable member of the health care team in the management of terminally ill patients. This in turn increases the quality of care as well as the quality of life for the hospice patient.