The Role of Pharmacy in Hospice Care

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Toward the end of her life, Scott Vouri’s grandmother entered hospice care.

“There are so many misconceptions about hospice,” says Vouri, Pharm.D., BCPS, CGP, assistant professor of pharmacy practice at St. Louis College of Pharmacy. “I found myself advocating not only for my grandmother, but for hospice programs in general.”

The number of patients receiving hospice care is growing steadily. The National Hospice and Palliative Care Organization (NHPCO) estimates around 1.5 million Americans utilized hospice services in 2012. That’s an increase of 20 percent in just four years. Pharmacists, who already play a vital role in the health care of patients, maintain that role during a patient’s final days.

“The main goal of hospice is to focus on the patient and to make them comfortable,” says Myra Belgeri ’97/’98. “Following through with the patient’s goals can be somewhat different than a patient who is not in hospice.”

Belgeri, Pharm.D., CGP, BCPS, FASCP, is a clinical pharmacist working as a consultant for hospice organizations and is a former College faculty member. In her role as a clinical pharmacist, she communicates with an interprofessional team of doctors, nurses, and social workers to ensure patients are on medications that are appropriate and keep them comfortable.

“The Centers for Medicare & Medicaid Services (CMS) state that a hospice patient’s medications must be reviewed by a person with specialized education and training in drug management,” Belgeri says. “There are a lot of times the patient has medications they don’t need or don’t want to take anymore.”

Hospice providers rely on pharmacists as the medication experts to know about drug management, including evaluating drug effectiveness, drug side-effects, drug interactions, drug duplications, and lab monitoring.

“Pharmacists give recommendations on which medications might be appropriate to stop as the patient enters hospice, or which ones may need to be tapered down,” Belgeri says. “We also recommend medications to treat symptoms that the patient has while they’re receiving hospice care. We recommend specific drugs to make them feel more comfortable.”

Belgeri says one of the biggest misconceptions about hospice is that it is only for cancer patients. The NHPCO estimates cancer patients make up about 37 percent of all hospice patients.

“Hospice services are available to anyone with a life-limiting or terminal disease.” Belgeri says. “Hospice is truly centered on the patient’s goals.”

The College will welcome Chris Herndon ’97/’98, a noted expert on hospice care, to campus for a presentation on Feb. 6 at noon in Jones 1390. Students interested in learning more about pharmacists’ role in hospice should contact fifth-year student Mason Stewart.

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