Pharmacist delivered patient care in an institutional palliative care clinic

Service or Program: The Palliative Care Clinic, located at the University of Arkansas for Medical Sciences’ (UAMS) Cancer Institute sees over 1600 follow-up and 200 new patients each year.  In 2012, a process of care (POC) involving a part-time clinical pharmacist (CP) in collaboration with other providers was instituted to deliver comprehensive medication management.  In March 2013, the CP position became full-time. The CP’s role involves working with providers to implement the best care plan for patients by: performing patient assessments, optimizing the patient’s medication therapy, education and counseling, follow-up phone evaluations, among others. The CP also presents at educational conferences including the regional Annual Hospice and Palliative Care Conference. The pharmacist is funded by the UAMS College of Pharmacy and holds the rank of Assistant Professor.

Justification/Documentation: A 16-month period of the POC was evaluated and revealed 10,264 documented CP interventions including approximately 850 pain and/or adjuvant medication consultations, 6,500 prescriptions written, 130 follow-up phone calls, 25 drug interaction consults/interventions, 815 patient assessments, etc. There were 1,292 patients seen by the CP.

Transferability: This POC could be implemented in many types of palliative care settings. One factor contributing to the CP’s success is the interdisciplinary team approach.  Each clinic was staffed with a physician, nurse, pharmacist, and social worker.  Chaplains and dieticians were also available.

Impact: A CP in this clinic benefits many stakeholders.  First, patients benefit by having a medication expert available to answer questions and review their medications.  Second, other providers benefit because services provided by the CP allow them to focus their attention in other areas of patient care. With a growing emphasis on providing interdisciplinary educational experiences, sites such as the UAMS Palliative Care Clinic also benefits students in multiple health professions by providing the opportunity to learn from professionals practicing in a team-based model to deliver quality patient-centered care.