Factors Contributing to the Degree of Burden on Pharmacists in Home Care

―Using Decision Tree Analysis―

Abstract

This study examined factors contributing to the degree of burden on pharmacists in home care and their causes. Based on the medication management records (346 cases), created by 6 insurance-covered pharmacies providing home care services in Aichi Prefecture, and using decision tree analysis, we analyzed the relationships between the degree of burden on pharmacists and 37 factors related to patients/home care (in-pharmacy services, home-visit services, services involving multiple professionals, and services to clarify patient conditions). Among the patient-related factors, pharmacists found <end-of-life care>, specifically intervention for patients with <malignant tumors>, the most burdensome. <Sterile preparation of prescription opioids> and the use of <designated therapeutic drugs> also influenced the degree of burden on them. Among the home care-related factors, <interprofessional collaboration> contributed the most to the degree of burden. On the other hand, the <number of prescription drugs>, <dispensing time>, and <mental distress of caregivers> also increased it. Home care service systems require a wide range of medical functions from support on discharge to the management of sudden changes and end-of-life care, in addition to daily care support. The results suggest that the sophistication of home care services provided by pharmacies is resulting in increased temporal and psychological burdens, and that pharmacotherapy is also becoming more complex. With a shift of their services from objects to persons, interpersonal communication-related factors may also have begun to influence the degree of burden on pharmacists.