Involvement of the pharmacy in home-based palliative care: a study involving patients who received sedative medications for pain relief

Abstract

Purpose: We investigated the involvement of the pharmacy, as a health care resource that supports regional palliative care, in the treatment of patients who received continuous sedation during home-based care. Method: Of the home-based patients with end-stage diseases who received guidance for the management of home-based care between January 2011 and December 2012, this study involved 13 patients who were treated with sedation to relieve pain, and died at home. The survey items included the improvement of pain levels after the initiation of sedation, the number of prescriptions for sterile preparations, number of home visits made by physicians and pharmacists, and the change in the purpose of home visits made by pharmacists. Result: The improvement of pain levels was 76.9%. The number of prescriptions for sterile preparations and that of home visits made by physicians and pharmacists (per day) significantly increased after the initiation of sedation. Concerning the change in the purpose of home visits, an "emergency situation" became significantly more prevalent. Conclution: In the care of patients undergoing sedation at home, it is necessary to have physicians who can respond to emergency situations; thus, a similar system must be established for the pharmacy as a health care resource that supports regional care.