An overview of pharmacist roles in palliative care: a worldwide comparison

Background. In order to fulfil the complex needs of terminally ill patients, palliative care demands an in­ter-professional collaborative network, including doctors, nurses, dieticians and social workers. Pharmacists in particular are essential members of this team, given the level of reliance on medications in this setting. The purpose of this review is to identify roles and services performed by palliative care pharmacists in dedicated palliative care settings worldwide and to map these findings against the Advanced Pharmacy Practice Framework. Material and methods. Quasi-systematic review. Search strategy: Google Scholar, Medline/PubMed, Scopus and Embase were searched utilizing selected MeSH terms. Results. A total of 24 sources of information were included in the review. This literature was collected from a range of countries, predominantly from the USA, UK and Australia with singular reports from Mexico, Japan, Qatar, Canada, Poland and Sweden. The literature identifies that pharmacist roles in palliative care are varied and quite extensive. Roles that were specifically tailored to the palliative setting included: aggressive symptom management (in particular pain control), deprescribing, advising on the use of complementary and alternative therapies, extemporaneous compounding of non-standard dosage forms and maintaining a timely supply of medications. Pharmacists in the UK, USA, Canada and Australia were found to perform an advanced level of practice (as their reported roles fulfilled the criteria of the majority of the domains in the APPF). However, pharmacists in other countries, in particular Mexico and Poland, did not present such an extensive scope of practice. Conclusion. The literature identifies that there are differences in the types of palliative pharmacist practice between countries, which may have varying levels of impact upon patient outcomes. As pharmacists can make significant contributions to palliative care, it is important to encourage the benchmarking of practice across different clinical settings and countries to promote a consistent and equitable practice

An overview of the use of drugs in palliative care settings worldwide

Introduction: To provide an overview of drug use in palliative care worldwide and to identify the mostcommonly used medicines in palliative care settings.Methods: Quasi–systematic review. Search strategy: Medline/PubMed, Embase, SCOPUS and GoogleScholar were searched utilizing the selected MeSH terms: palliative care, hospice, drug utilization, andprescription patterns.Results: Overall, it is apparent that there is a significant lack of published literature outlining drug usage inpalliative care settings. Twelve sources of information were reviewed from 9 different countries includingAustria (n = 1), Brazil (n = 1), Canada (n = 1), Germany (n = 1), Italy (n = 2), Netherlands (n = 2), Norway(n = 1), Switzerland (n = 1) and USA (n = 3), as well as a multinational study comparing 11 European countries.Medication use between countries was similar. The most commonly prescribed classes of medicinesincluded non-opioid analgesics, opioids, laxatives, sedatives and antipsychotics and the most commonlyprescribed individual drugs comprised morphine, haloperidol, laxatives and paracetamol.Conclusions: The literature identifies that there is insufficient evidence to describe and compare what drugsare currently used in palliative care settings worldwide. This is attributed to the lack of recently publishedarticles leading to a large gap in knowledge in understanding drug utilization practices in palliative care.Further research is required to address these gaps in knowledge, and identify medication management issuesin palliative care and determining whether there are significant differences in drug management practices. Palliat Med Pract 2019; 13, 3: 134–14

Selected aspects of nutrition in palliative care

Proper nutrition in palliative care is essential to achieve a good quality of life of patients and better treatmentresults. The diet should include the proper amount of calories and nutrients such as proteins, omega 3 fattyacids, dietary fibre, vitamin D and vitamin C. The meals must be balanced, tasty, diverse and appetizing.In this paper, an example of one-day diet for adult palliative care patients is proposed. Palliat Med Pract 2019; 13, 1: 17–2

Neonatal abstinence syndrome in a newborn delivered by an opioid-dependent mother using methadone substitution therapy during pregnancy

Introduction. Psychoactive substances as opioids used by women during pregnancy can have a negativeimpact on the health of a newborn child.Case report. Based on a case report of a newborn delivered by an opioid-dependent mother, this articledescribes the therapeutic decision-making that occurred in caring for this patient. This included outliningthe form of substitution therapy selected and the use of Finnegan’s scoring system to assess the degreeof abstinence syndrome in the newborn.Conclusion. There is a need to monitor drug-dependent women and their children from the early stagesof pregnancy through to birth to ensure positive health outcomes for both the mother and the newborn

Treść ulotek dołączonych do analgetyków opioidowych — ocena wybranych informacji z perspektywy pacjenta i innych użytkowników

Introduction. Patient information leaflet (PIL), enclosed to the drug, is the basic source of information provided for the patient, caregivers, physicians and pharmacists. The usage of opioid analgesics (because of safety of the treatment) requires education of the patient. Therefore, the information included in the PILs, as well as its presentation is essential. Material and methods. The information included in PILs of 17 commonly used opioids has been the material of the study. The applied method based on an analysis of the contents of the PILs with a focus on patients’ and other people’s safety. Results. The analysis has indicated that, in general, key messages provided in all PILs are similar and the content of PILs meets the minimal legal requirements. However, it has been found that the information in some PILs is incomplete, what in turn, may affect the safety of the patient and others, e.g. children. There is also apparent discrepancy between the density of information written in particular PILs and the details they include as well as the usage of medical terminology. Conclusion. In general, the scope of information included in PILs of opioids registered in Poland is in accordance with legal regulations. The differences are visible in detailed information and it may influence patient’s and other people’s safety. Some of the PILs have extended information, while others include only short comments or do not contain the particular issues. Moreover, not all PILs explain in details medical terms, that are not understandable for the users. This inconsistent and incomplete information may lead to misunderstanding of the drug pharmacologic action by the patients, physicians or pharmacists.Wstęp. Ulotka dołączona do opakowania leku jest podstawowym źródłem informacji dla pacjenta, jego opiekunów oraz lekarzy i farmaceutów. Stosowanie analgetyków opioidowych, ze względu na bezpieczeństwo farmakoterapii, wymaga edukacji pacjenta, dlatego zarówno informacje zawarte w ulotkach dotyczących opioidów, jak i sposób ich prezentacji nabierają szczególnego znaczenia. Materiał i metody. Informacje zawarte w ulotkach 17 najczęściej stosowanych leków opioidowych stanowiły materiał przedmiotowego badania, w którym go oceniono lub poddano analizie porównawczej z perspektywy bezpieczeństwa pacjenta i innych osób, które potencjalnie mogą dany lek zastosować. Wyniki. W wyniku przeprowadzonej analizy ustalono, że struktura poszczególnych ulotek jest podobna, a ich treść z reguły spełnia minimalne wymagania wynikające z przepisów prawa. Niemniej jednak stwierdzono, że w części z nich brakuje szeregu informacji, które mogą być istotne z uwagi na bezpieczeństwo pacjenta i innych osób, np. dzieci. Różnice wynikają również ze stopnia szczegółowości zamieszczonego w ulotce opisu oraz sposobu użycia specjalistycznej terminologii medycznej i jej wyjaśnienia. Wnioski. Zakres informacji zawartych w treści ulotek opioidów stosowanych w Polsce z reguły jest zgodny z wymaganiami wynikającymi z przepisów prawa. Natomiast różnice dotyczą sposobu opisania w ulotce zagadnień szczegółowych, istotnych z perspektywy bezpieczeństwa pacjenta i innych osób. Część ulotek zawiera rozszerzoną informację, podczas gdy w pozostałych występują jedynie ogólne stwierdzenia lub część zagadnień została pominięta. Ponadto nie wszystkie ulotki zawierają wyjaśnienia terminów medycznych, które mogą być niezrozumiałe dla pacjentów i ich bliskich. Stwierdzone braki mogą wprowadzać w błąd zarówno pacjentów, jaki i lekarzy oraz farmaceutów

The Polish palliative care response to the war in Ukraine and the subsequent humanitarian crisis

The Russian invasion of Ukraine has caused a serious humanitarian crisis. The Ukrainian healthcare system has collapsed and many health care institutions, including palliative care facilities, have been destroyed. In Poland, hospices and palliative care centres, non-governmental and public organizations, local authorities as well as individual citizens have been involved in the provision of care and other forms of support for palliative care patients who fled Ukraine. Due to the implementation of new regulations, 1.5 million refugees have been granted access to Polish public services. The rapid aid response for Ukrainian refugees has provided these patients with dignity, by meeting their basic needs, and allowed them to experience some level of peace in a deeply troubling time

Pielęgniarstwo na rzecz milenijnych celów rozwoju. Cz. 2

Praca recenzowana / Peer-reviewed paperZ przyjemnością oddajemy w Państwa ręce drugi tom monografii wydanej z okazji XII Kongresu Pielęgniarek Polskich w Krakowie, w którym udział wzięło blisko 500 pielęgniarek, zaprezentowano 160 prac w 9 sesjach. Ta kolejna już publikacja świadczy o dynamicznym rozwoju badań naukowych w pielęgniarstwie. Dowodzi, że pielęgniarstwo to nie tylko zawód, ale i interdyscyplinarna nauka

Ocena możliwości wprowadzenia opieki farmaceutycznej nad pacjentami z wybranymi chorobami cywilizacyjnymi - uwarunkowania prawne, organizacyjne i socjologiczne

Praca wykonana w: Wydział Farmaceutyczny

How to teach pharmacology to medical students during the COVID-19 pandemic?

BackgroundThe COVID-19 pandemic has forced the introduction of many changes into medical student education. The aim of the study was to evaluate medical students’ perceptions of a Pharmacology course delivered at a Polish medical university before and during the pandemic.Material and methodsA cross-sectional anonymous survey conducted among medical students.Results90 out 122 students participated in the study. The vast majority of students found pharmacology to be a difficult subject. The surveyed group of students preferred active methods of learning, including: teacher explanations (86.5%) and discussions (70.8%) during in-person classes, real-time student-teacher meetings via dedicated web-based platforms (73%) during online classes. Students most often described e-learning as interesting (58.9%) and timesaving (52.2%). Less than 30% described it as stressful, difficult, time-consuming and boring. The most commonly reported advantage was the possibility for students to adjust their pharmacology study-time to a more personalised schedule (82.5%). The main disadvantage included the loss of in-person face-to-face contact with the teacher (61.8%).ConclusionsOverall, students held positive attitudes towards the new teaching format and adapted well to the new conditions. Modern innovations enabling medical students to continue their studies efficiently and effectively during the pandemic must be developed and introduced into practice