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Qualms about data sharing hampering pharmacists’ palliative care role

And poor integration into primary care teams doesn’t help either, concludes preliminary research

Caroline White

Friday, 13 April 2018

Attempts to increase community pharmacists’ involvement in palliative care provision are being hampered by qualms about data sharing and poor integration into primary care teams, suggests preliminary research, presented at the Health Services Research and Pharmacy Practice Conference at Newcastle University this week (12-13 April).

Better integration and data sharing between primary care teams would boost timely access to medications for patients, conclude the researchers, led by Elizabeth Miller from the University of Bradford.

Prompt access to palliative medicines at the end of life is critical for effective symptom control, but it’s not clear how much community pharmacists are able to contribute to this.

In a bid to identify the factors that might hinder or help, the researchers gathered anonymised prescription data from a sample of five community pharmacies in Sheffield and carried out in-depth individual semi-structured interviews with 16 community healthcare professionals.

These included five community pharmacists; three GPs, five community nurses; two palliative care team members; and one intermediate palliative care team member.

Two of the five pharmacies provide access to palliative medicine under a Locally Commissioned Service (LCS).

Three key themes emerged from the interviews: environment and resources; communication and collaboration; skills and knowledge.

Community pharmacists said they often had to be reactive as they had little advance notice. They described practical issues including: controlled drug cabinet size; national stock shortages; and ordering processes and prescriptions for items not on the local formulary.

A stock of palliative medicines in the pharmacy was key to ensuring that patients got the treatment they needed, they said.

The other community healthcare professionals said that they contacted the pharmacy to check availability, but that palliative care needs were not discussed in advance with pharmacists because of concerns about sharing confidential information.

Their knowledge and understanding of the LCS, and of the role of community pharmacist and pharmacy services in general in assisting patients with palliative care needs was poor.

Community healthcare professionals in turn worried that pharmacists were not familiar with pre-emptive prescribing, and didn’t understand how quickly medication was needed.

Despite national policy to increase community pharmacists’ involvement in palliative care they don’t have the clinical information they need and are poorly integrated into primary care teams to enable them do this, say the researchers.

This needs to be addressed if patients are to get the drugs they need when they need them, they conclude.

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