barnstorming, directing, producing: integration of a clinical pharmacist across the full spectrum of...

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evaluate and address them. Specifically, we will focus on the challenges of pain management, be- havioral disturbances, and caregiver burden. The goal will be to enhance participants’ skills in pro- viding comprehensive palliative care to older adults who have dementia but are dying of an- other terminal disease process. SIG Symposia Barnstorming, Directing, Producing: Integration of a Clinical Pharmacist Across the Full Spectrum of Palliative Care Services (341) Program Chiefs SIG Pamela Moore, PharmD BCPS, Summa Health System and Akron City Hospital, Akron, OH. Steven Radwany, MD FACP FAAHPM, Summa Health System, Akron, OH. (All authors listed above for this session have dis- closed no relevant financial relationships.) Objectives 1. Compare clinical pharmacist goals of care with Hospice Medicare Conditions of Participation. 2. Create a cost-benefit analysis for initially in- corporating a palliative care pharmacist in their program and the subsequent role of the clinical pharmacist across the full spec- trum of palliative care. 3. Describe the team, patient-centered, and program outcomes of having a clinical phar- macist integrated into hospice and palliative care interdisciplinary care teams. This presentation will focus on the role, bene- fits, outcomes, and costs of providing active clin- ical pharmacist involvement across the entire spectrum of interdisciplinary teams in an inte- grated hospice and palliative care (HPC) pro- gram. Given the burdens of illness, frailty, and polypharmacy borne by HPC patients, medica- tion side effects, interactions, and cost become central concerns. Palliative care and pharmaceu- tical care both focus on achieving the best qual- ity of life for patients and families in the setting of their choice. Incorporating a pharmacist di- rectly into the interdisciplinary care of HPC pa- tients across all sites of care is a logical step in the comprehensive management of symptoms in a safe and cost-effective manner. Presenters will describe how a pharmacist can be success- fully integrated into the care of patients across the full spectrum of HPC services including inpatient and extended care facility palliative care consult services, an inpatient acute pallia- tive care unit, a palliative care outpatient clinic and home, and long term careebased hospice care. The pharmacist serves as a resource for drug information in this patient population for which evidence-based guidelines are limited and where reliable routes of medication administra- tion change frequently. The pharmacist works with physician and nurse members of the inpa- tient and outpatient services to capitalize on avail- able evidence to develop and revise cost-effective and consistent medication options for inpatient and outpatient symptom management protocols. Central to the pharmacist role is patient, staff, and physician education and collaboration regarding the safe and effective use of medications which may be off-label and outside the comfort level of healthcare providers and caregivers. Outcomes presented will include job descriptions, net cost savings achieved, protocols developed, and staff satisfaction with the program. Presenters will also advocate for expanding specific HPC training and certification programs for pharmacists. Chemotherapy in the Last Two Weeks of Life: When Is It Appropriate? When Is It Not Appropriate? (342) Cancer SIG Eric Prommer, MD FAAHPM, Mayo Clinic, Phoenix, AZ. Sydney Dy, MD MSc, Johns Hop- kins University Baltimore, MD. Lynn Billing, BSN RN CHPN B-C Ò , Kimmel Cancer Center at the Johns Hopkins Hospital, Baltimore, MD. Mary Buss, MD, Beth Israel Deaconess Medical Center, Boston, MA. Thomas Smith, MD, VCU Massey Cancer Center, Richmond, VA. (All authors listed above for this session have dis- closed no relevant financial relationships.) Objectives 1. Recognize the impact of chemotherapy ad- ministration late in the life of the cancer patient. 2. Recognize treating physician, patient, and family factors that lead to late chemotherapy administration. 3. Identify communication issues that lead to late chemotherapy administration. Quality of life is an important outcome for pa- tients who are dying of cancer. Ideally, services used near the end-of-life should minimize aggres- sive interventions and focus on symptom control and supportive care. Care ‘should also be Vol. 43 No. 2 February 2012 365 Schedule With Abstracts

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Page 1: Barnstorming, Directing, Producing: Integration of a Clinical Pharmacist Across the Full Spectrum of Palliative Care Services (341): Program Chiefs SIG

Vol. 43 No. 2 February 2012 365Schedule With Abstracts

evaluate and address them. Specifically, we willfocus on the challenges of pain management, be-havioral disturbances, and caregiver burden. Thegoal will be to enhance participants’ skills in pro-viding comprehensive palliative care to olderadults who have dementia but are dying of an-other terminal disease process.

SIG Symposia

Barnstorming, Directing, Producing:Integration of a Clinical Pharmacist Acrossthe Full Spectrum of Palliative CareServices (341)Program Chiefs SIGPamela Moore, PharmD BCPS, Summa HealthSystem and Akron City Hospital, Akron, OH.Steven Radwany, MD FACP FAAHPM, SummaHealth System, Akron, OH.(All authors listed above for this session have dis-closed no relevant financial relationships.)

Objectives1. Compare clinical pharmacist goals of care with

HospiceMedicareConditions of Participation.2. Create a cost-benefit analysis for initially in-

corporating a palliative care pharmacist intheir program and the subsequent role ofthe clinical pharmacist across the full spec-trum of palliative care.

3. Describe the team, patient-centered, andprogram outcomes of having a clinical phar-macist integrated into hospice and palliativecare interdisciplinary care teams.

This presentation will focus on the role, bene-fits, outcomes, and costs of providing active clin-ical pharmacist involvement across the entirespectrum of interdisciplinary teams in an inte-grated hospice and palliative care (HPC) pro-gram. Given the burdens of illness, frailty, andpolypharmacy borne by HPC patients, medica-tion side effects, interactions, and cost becomecentral concerns. Palliative care and pharmaceu-tical care both focus on achieving the best qual-ity of life for patients and families in the settingof their choice. Incorporating a pharmacist di-rectly into the interdisciplinary care of HPC pa-tients across all sites of care is a logical step inthe comprehensive management of symptomsin a safe and cost-effective manner. Presenterswill describe how a pharmacist can be success-fully integrated into the care of patients acrossthe full spectrum of HPC services including

inpatient and extended care facility palliativecare consult services, an inpatient acute pallia-tive care unit, a palliative care outpatient clinicand home, and long term careebased hospicecare. The pharmacist serves as a resource fordrug information in this patient population forwhich evidence-based guidelines are limited andwhere reliable routes of medication administra-tion change frequently. The pharmacist workswith physician and nurse members of the inpa-tient and outpatient services to capitalize on avail-able evidence to develop and revise cost-effectiveand consistent medication options for inpatientand outpatient symptommanagement protocols.Central to the pharmacist role is patient, staff, andphysician education and collaboration regardingthe safe and effective use of medications whichmay be off-label and outside the comfort level ofhealthcare providers and caregivers. Outcomespresented will include job descriptions, net costsavings achieved, protocols developed, and staffsatisfaction with the program. Presenters willalso advocate for expanding specificHPC trainingand certification programs for pharmacists.

Chemotherapy in the Last Two Weeksof Life: When Is It Appropriate? WhenIs It Not Appropriate? (342)Cancer SIGEric Prommer, MD FAAHPM, Mayo Clinic,Phoenix, AZ. Sydney Dy, MD MSc, Johns Hop-kins University Baltimore, MD. Lynn Billing,BSN RN CHPN B-C�, Kimmel Cancer Centerat the Johns Hopkins Hospital, Baltimore, MD.Mary Buss, MD, Beth Israel Deaconess MedicalCenter, Boston, MA. Thomas Smith, MD, VCUMassey Cancer Center, Richmond, VA.(All authors listed above for this session have dis-closed no relevant financial relationships.)

Objectives1. Recognize the impact of chemotherapy ad-

ministration late in the life of the cancerpatient.

2. Recognize treating physician, patient, andfamily factors that lead to late chemotherapyadministration.

3. Identify communication issues that lead tolate chemotherapy administration.

Quality of life is an important outcome for pa-tients who are dying of cancer. Ideally, servicesused near the end-of-life shouldminimize aggres-sive interventions and focus on symptom controland supportive care. Care ‘should also be