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Methods: In 2005, a pharmacist with clinical background was assigned to lead the palliative clinical pharmacy service. She started by receiving didactic and clinical training in the area of palliative care from local and international experts. The following year, she was appointed as a full time palliative care pharmacist. She attended daily interdisciplinary rounds, reviewed medical profiles, developed pharmaceutical care plans, conducted medication reconciliation, and provided bedside patient education upon admission and at discharge. Two years later, the palliative clinical pharmacy service was expanded to cover the palliative outpatient clinics, where the pharmacist directly interacted with the patients to enhance compliance with their medications. Other responsibilities include a wide range of educational , and research activities.
Results: Five years after introducing the palliative clinical pharmacy service, the palliative care team continues to view the pharmacist as an essential member. About 500 patients per year are referred to the palliative service and about 450 patients per year are admitted to the hospital under their service. Over the 5 years, a total of 3452 interventions were reported and the physician acceptance rate was >95%. The most common were drug therapeutic recommendations (n=1209, 32%), patient counseling/drug information (n=761, 22%) and dose evaluation/adjustment (n=527, 15%).
Conclusion: In a country with limited resources, the implementation of a clinical pharmacy service in palliative care was feasible. In addition, the presence of a palliative clinical pharmacist had a significant impact on optimizing the therapeutic management of patients.