Providing Relief to Patients In Their Last Days

wheelchairWhen a patient’s health deteriorates to the point where treatment is no longer an option, physicians and caregivers turn their focus to making the patient as comfortable as possible. Patients may be given hospice care at home, or may be transferred to a hospice facility. Hospice care aims to improve or maintain the quality of life by seeing to the patient’s physical, emotional and spiritual needs.

Part of that equation is medication management. Medication management is an important aspect of palliative care, or care designed to relieve the discomfort, pain and stress related to a life-threatening illness. Patients may be given medication to control symptoms such as pain, anxiety, nausea or vomiting.

According to Bridget McCrate Protus, Pharm.D, Director of Drug Information at pharmacy benefit manager HospiScript Services, the challenges of medicating end-of-life patients vary from case to case. The goals of the family and the patient may not match the goals of healthcare providers. Physicians may still want to treat the patient with chemotherapy or other interventions, while the patient and the family may choose quality of life over aggressive therapies. In other cases, the challenge arises from educating the patient and the family on how medications can alleviate symptoms of terminal illness.

HospiScript Services handles both the administrative and clinical aspects of pharmaceutical care within the hospice industry. The Montgomery, Ala.-based company processes pharmacy claims and provides pharmaceutical education for hospice programs. HospiScript staffers work with hospice nurses, case managers, physicians, and patients and their families to help select the appropriate medication for a patient’s symptoms. McCrate Protus expects the demand for end-of-life care to grow as the U.S. population ages. “More and more people are becoming aware of the benefits and the quality of care that hospice provides.”

Although the industry is currently battling two federal cuts to hospice reimbursement, provisions in President Obama’s healthcare reform bill aim to expand patient access to hospice care and improve quality measures in hospice facilities. Over 1.4 million patients are currently being cared for in hospice programs throughout the U.S. Companies such as VITAS Healthcare Corporation and Gentiva Health Services provide hospice and home care services to patients suffering from terminal illness. Another company, excelleRx, Inc., specializes in medication consultation and pharmaceutical distribution for niche disease markets. excelleRx uses its proprietary software to interpret patient data and assist in the development of a pharmacotherapy program. Among other services, the company offers medication billing services and a 24/7 pharmacy support center.

What role do you think hospice care will play in the future of healthcare? Will the provisions in the healthcare reform bill help or hurt the hospice industry?

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