A Pharmacist’s role is beyond just dispensing medications
– Ms. Saroja Gangaiah, Bengaluru
When asked ‘What is the role of a pharmacist?’, the usual response is ‘To provide care to patients by dispensing those drugs recommended by the doctors’. Right? Well, let me tell you that it is certainly not limited to just that.
Yes, the delivery of medication is a major part of a Pharmacist’s job; however, our role extends beyond medication dispensing to also include the provisioning care to both patients and their caregivers. Pharmacists therefore need to be recognised as a core and an integral member of the health care team provisioning palliative care.
Palliative care services are often provided by a multidisciplinary team of doctors, nurses, counsellors, pharmacists, social workers, volunteers and other health care professionals, whose principle responsibility is to render quality care and allow for the best quality of life for both the patient and the caregiver.
Despite this, there is only a very small quantum of pharmacists from across the country are involved in the provisioning of palliative care services. I have been fortunate to be affiliated with Kidwai Memorial Institute of Oncology and Cancer Research Institute, a Regional Cancer Center. This center pioneered the dispensing of oral morphine solution, in India from 1988, and was also instrumental in launching the Karnataka State Palliative Care Policy in 2016. Implementation of this State Palliative Care Policy resulted in a few doctors, nurses and pharmacists to be sensitized and trained in palliative care, from a few districts across the State of Karnataka.
As a pharmacist, I have been able to contribute significantly to the palliative care team as I am able to render both direct patient care as well as offer supportive care to other health professionals, along with the patient and the caregivers. Personally, my Role provides me with immense satisfaction, both at a personal and at a professional level.
The below mentioned avenues are opportunities for a pharmacist to render direct patient care:
- Participating in team rounds helps review medication and better monitor and address the adverse effects and medication interactions
- Reviewing medication opens up the freedom for pharmacists to rationalise discussions with patients and their caregivers to improve consumption of medication and its adherence. These conversations will allow the team to better understand how patients take their medicines and explain to them the implications of missing a dose of medication, all of which will significantly impact on the patients’ quality of life
- Counselling and supporting patients and their caregivers by discussing their fears of overdosing or addiction of opioids
- Pharmacists can also educate and empower patients and their caregivers by:
- providing them with written instruction sheets to encourage timely consumption of medication and track timely refill of medications
- Promoting the maintenance of a drug diary to monitor drug reactions and help manage the risks and the associated side-effects of the prescribed regimen
- Improving the patients confidence by helping suitable patients to independently manage their medication
- Following up with those discharged patients to ensure the proper management of medications
Similarly, Pharmacists can also provide a Supportive role for other team members which include:
- Assisting other health care professionals in patient assessment and addressing their medication related enquires
- Educating and training other staff members on the administration of medications regularly used in palliative care
- Getting actively involved in clinical meetings to provide the team with updates on new medication guidelines
Pharmacists working in community based palliative care set ups can offer support by developing and forging good rapport with patients and their caregivers, which will allow them to provide ongoing psychosocial support throughout the different stages of a patient’s illnesses. Caregivers can continue to be cared for by offering bereavement support.
The Pharmacist can also discharge and help with other administrative roles such as:
- Communicating with the concerned regulatory and the licensing authorities to ensure compliance of documentation and procurement of essential narcotic drugs
- Effective and efficient management of medication (safe storage, dispensing and documentation of the medicine) to ensure the regular supply of medication
- Encourage the benchmarking of practices across centres’ and across different clinical settings to promote consistent and equitable practices
Thus, there exists an immense need for pharmacists from across the country to network, support and empower one another to ensure the effective implementation of quality palliative care. Once empowered these pharmacists can leverage their relationships with patients and caregivers to provision quality palliative care services even in the grass root levels of the country where resources are constrained and access is limited.
Incidentally, ‘World Pharmacists Day’ is observed globally on 25 September to acknowledge the pivotal role of pharmacists and to remind people to accept pharmacists and their services with respect. It is therefore only imperative and apt for the palliative care community to mirror the theme of this year’s World Hospice and Palliative Care Day, ‘Leaving no one behind – equity in access to Palliative Care’ and also resonate the theme of this year’s World Pharmacist’ Day, ‘Pharmacy: Always trusted for your health’, as trust, is one of the most valued ethos of palliative care.
About the Author: Ms. Saroja Gangaiah is a Pharmacist, at the Department of Palliative Medicine, Kidwai Memorial Institute of Oncology, Bengaluru. She is also a Central Council Member, South Zone, IAPC and a National Faculty for the IAPC.