Hospice Care: What is Pharmacopalliation and What You Should Know

Pharmacopalliation is certainly a mouthful but its definition is simple. It’s designed to review and analyze all the medications a particular patient takes to make sure the benefits of each medicine outweigh the risks. At its core is palliative care, which involves the treatment or prevention of symptoms and side effects associated with disease, according to MedlinePlus. It can also treat emotional, social, practical and spiritual problems brought about by illness to improve quality of life, often provided at the same time as treatments designed to cure or treat the disease. Palliative care can be used in illnesses such as cancer, heart disease, kidney failure, lung disease and ALS, among others. Palliative care is often an integral part of hospice care, as recipients are generally experiencing advanced and life-threatening illnesses.

What is Pharmacopalliation?

Pharmacopalliation is important because it questions the need for certain medications. Often times, patients have “always taken” a particular medication, but those behind pharmacopalliation will ask: does the patient still need it? What is the benefit? IS there a benefit to continuation? This is for the safety of the patient as well as their continued comfort. Combining the wrong prescriptions and herbal treatments can be detrimental to a patient’s health. Approximately 1.5 million people in this country are harmed every year by medication errors, according to a report on WebMD.

With July being Herbal/Prescription Interaction Awareness Month, we thought this topic would be an appropriate one this week. While the harmful combination of prescription pharmaceuticals is well known, sometimes we forget that herbal supplements can be dangerous too. There’s a big misconception that because herbs are all-natural, that they are safe to take, points out iGrow. However, keep in mind that even herbs can have dangerous properties when taken in conjunction with something else. For example, cranberry herbal supplements should never be taken with blood thinners due to adverse reaction.

What You Should Know

Pharmacopalliation aims to take a close look not just at each drug but how they all interact with each other. Many people receiving palliative care in hospice take several combinations of prescription drugs and even herbal medicines. Not only is it dangerous to mix and match prescribed medications, most herbal supplements are not approved for use by the FDA. This lack of federal oversight for herbs, combined with the perception that because herbs are not pharmaceuticals and therefore are somehow less potent and harmful, can lead to overdosing of herbal supplements as well as dangerous combinations, according to How Stuff Works Health.

Many medications for patients in hospice care or even beforehand often start out due to clinical practices and anecdotal history. However, there needs to be more sound evaluation into the medications a patient receives based on current evidence so as to prevent misuse. Reconciling evidence with past history and anecdote takes extra resources and dedicated expertise.

Many hospice care organizations, like Pathways Home Health and Hospice, offer a comprehensive care team that includes a pharmacist. This pharmacist can collaborate with physicians and nurses to prevent unwanted side effects and drug interactions with patient medications. These professionals work one on one with the medical care team to ensure the patient is receiving medications and herbal supplements in line with their particular illness. They check in with the team on a weekly basis or sooner for all their patients, going over any new medications that may have been prescribed by the doctor. This includes talking with the patient about any herbal supplements he or she may be interested in taking.

A Brief Overview of the Process

At the heart of pharmacopalliation is the communication of patient-centered, evidence-based recommendations to recommend or discourage medications as part of hospice and palliative care. Every organization is different in how they assess pharmacopalliation. Here’s a brief overview of what may be involved:

  • Respond to complaint of pain
  • Perform subjective assessment and physical exam
  • Determine root of pain
  • List opioids and non-opioids used in the treatment of pain
  • Compare side effects and possible interactions
  • Recommend new course of action, i.e., adjust the dose or stop medication, if needed
  • If not, review medication list regularly to ensure no new issues arise

Your loved one’s pharmacist should give you an update on a regular basis so you know exactly what the patient is taking and any possible side effects associated with it. You can request a phone or in-person meeting to stay abreast of these ongoing issues.

Contact Pathways Home Health and Hospice

We offer palliative care as part of hospice here at Pathways Home Health and Hospice. Part of that care is to provide a well-rounded team of caregivers, including a pharmacist who can review your loved one’s medications. To learn our perspective of pharmacopalliation and to learn a bit more about our hospice services, contact us today at 888-755-7855.