Why rural pharmacists are key to home-based palliative care

New research has revealed the key role that pharmacists play in supporting home-based palliative care patients.

A pilot program was initiated by the Pharmaceutical Society of Australia and funded through the South Australian Department for Health and Wellbeing. It enabled a pharmacist to provide home-based care services in regional South Australia. The current study assessed this model of care by exploring the experiences of healthcare professionals who had worked with palliative care patients involved in this pilot.

Conducted by the University of South Australia, the study showed that home palliative care pharmacists can improve medication management, enhance communication between patients and their treating teams, and decrease the burden of going to the GP.

The study specifically assessed the real-world impact of home palliative care pharmacists in rural South Australia, and the effectiveness of this model of care from the perspectives of healthcare professionals.

Each year, about 56.8 million people, including 25.7 million in the last year of life, need palliative care. Worldwide, only about 14% of people who need palliative care currently receive it. Global demand for palliative care services is increasing due to an ageing population.

Lead researcher and pharmacist Tash Downing said while pharmacists are not typically recognised as part of a home palliative care team, they play an extremely valuable role.

“Many palliative care patients prefer to be cared for at home, where they are most comfortable and closer to loved ones. However, home-based care comes with many challenges, one of which is medication management,” she said.

“Proper medication management can provide relief from symptoms and improve quality of life, but this can be burdensome for patients, their carers, and their other healthcare professionals.

“Our study found that including a pharmacist in the rural palliative care team can help alleviate rural workforce shortages and improve the quality of care that is available for rural palliative patients.

“Importantly, a locally based pharmacist enables palliative patients [to have] more choice — they can receive trusted care in their own home, they have a local team who can coordinate prescriptions and medications, they don’t have to travel as much to appointments, and their level of distress is lower.

“Additionally, health professionals in this study thought that the home palliative care pharmacist improved communications between the patient and the treating team, cut the workload for other health professionals, and reduced the disparity of care between rural and urban patients.”

Co-researcher Dr Gemma Skaczkowski from the Department of Rural Health at the University of South Australia said that this rural model of palliative care has proven extremely successful in the rural areas involved in the pilot study.

“By highlighting the benefits and challenges of the pharmacist role as seen by other healthcare professionals, we can draw more attention to the need for such a model of care in rural areas and, ultimately, improve the palliative experience for patients, regardless of where they live,” she said.

“Further work to understand how to sustainably fund this model of care and what optimal implementation of this role looks like on a broader scale is now needed.”

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