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P254 The Effects of Pharmacotherapy Counselling Sessions in Pediatric Palliative Care (PPC) to Improve Medication Adherence
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Selected Abstracts
Objectives: We conducted a systematic review to identify structure, process and outcome indicators of quality palliative care for children with life-threatening conditions and their families, and evaluate how these indicators are measured. Methods: We conducted our search using three electronic databases (CINAHL, MEDLINE, Embase) and a combination of the following key word terms: palliative care, healthcare quality, and quality assessment / improvement / measurement / metrics or preferred practices. Results were limited to studies in children, aged 0-18 years. Book chapters, theses and conference abstracts were excluded. Titles and abstracts were reviewed for relevance, followed by full article review for all retained articles. Two reviewers were involved at each level of review. Results: After removal of duplicates, 5909 titles and abstracts were screened for relevance, 1322 full articles were reviewed, and 121 articles were included in the final review. Key indicators included: availability of specialised PPC services (including bereavement care); proportion of children suffering from a variety of symptoms; proportion of families with documented discussions of goals of care; proportion of children dying in their preferred location; and proportion of parents satisfied with PPC service provision. Conclusions: There are a number of indicators and associated measures for assessing the quality of pediatric palliative care, however further work is required to validate these indicators and identify additional outcome indicators. Identification of key quality indicators provides a foundation for critical validation work and assessment of the impact of interventions designed to improve the quality of pediatric palliative care.
P254 The Effects of Pharmacotherapy Counselling Sessions in Pediatric Palliative Care (PPC) to Improve Medication Adherence
Azza Abdel-Aty1,2, Saima Ali1,2 Bayt Abdullah Children’s Hospice, Sulaibikhat, Kuwait 2 Sabah Pediatric Hospital, Kuwait City, Kuwait
Vol. 52 No. 6 December 2016
medication was extracted from patient files during the first consultation. Counseling sessions focused on the following: Education regarding drug dosage, administration, treatment, adverse effects, interactions and over or under utilization. Discussion with patients /carers with an emphasizing the importance of adhering to the prescribed drug regime and ensuring that they understand and feel confident to follow the directions provided. Clarifying misconceptions regarding addiction, dependence and tolerance. Managing cessation or dose reduction of long term medications and implications for psychological and physiological harm. Balancing benefits and risk in the context of a changing clinical picture Ensuring medications remain appropriate Maximizing the patient’s period of functional independence. Following the consultation, post counselling medication review was achieved by completing the medication record chart. Results: Seven cases (oncological N¼ 6 and hematological N¼ 1) were referred to the hospice pharmacist. Follow-up visits revealed care taker adherence to medication improved in each case. Positive testimonials from carers who were previously reluctant to use opioids described improvements in physical symptoms and quality of life. Best pharmaco-therapeutic solutions were identified further. Conclusion: High quality PPC requires both traditional and expanded pharmacist services as they can contribute to positive outcomes of pharmacotherapy. In my experience in hospice care, pharmacological counselling is a key approach to treatment modality in symptoms management. Continuous education and counselling is fundamental for the patients and families to improve their drug compliance.
1
Objectives: Adherence to beneficial drug therapy is an essential component in improving and maintaining quality of life in PCC patients. The aim was to examine the role of the hospice pharmacist in improving adherence and knowledge about pharmacotherapy in PPC patients referred to hospice. Methods: Hospice patients with a history of suboptimal medication adherence and non-compliance were referred for a pharmacy consultation with the hospice pharmacist between Jan-Dec 2015. History of
P256 The Spiritual Impact of a Life-Limiting Diagnosis In-Utero
Sarah Meaney1, Daniel Nuzum2,3, Keelin O’Donoghue2,3 1 National Perinatal Epidemiology Centre, University College Cork, Ireland 2 University College Cork, Cork, Ireland 3 Cork University Maternity Hospital, Cork, Ireland
The diagnosis of a life-limiting condition in-utero is a devastating experience for parents and their wider family. Parents begin the process of grieving before
Selected Abstracts
Objectives: We conducted a systematic review to identify structure, process and outcome indicators of quality palliative care for children with life-threatening conditions and their families, and evaluate how these indicators are measured. Methods: We conducted our search using three electronic databases (CINAHL, MEDLINE, Embase) and a combination of the following key word terms: palliative care, healthcare quality, and quality assessment / improvement / measurement / metrics or preferred practices. Results were limited to studies in children, aged 0-18 years. Book chapters, theses and conference abstracts were excluded. Titles and abstracts were reviewed for relevance, followed by full article review for all retained articles. Two reviewers were involved at each level of review. Results: After removal of duplicates, 5909 titles and abstracts were screened for relevance, 1322 full articles were reviewed, and 121 articles were included in the final review. Key indicators included: availability of specialised PPC services (including bereavement care); proportion of children suffering from a variety of symptoms; proportion of families with documented discussions of goals of care; proportion of children dying in their preferred location; and proportion of parents satisfied with PPC service provision. Conclusions: There are a number of indicators and associated measures for assessing the quality of pediatric palliative care, however further work is required to validate these indicators and identify additional outcome indicators. Identification of key quality indicators provides a foundation for critical validation work and assessment of the impact of interventions designed to improve the quality of pediatric palliative care.
P254 The Effects of Pharmacotherapy Counselling Sessions in Pediatric Palliative Care (PPC) to Improve Medication Adherence
Azza Abdel-Aty1,2, Saima Ali1,2 Bayt Abdullah Children’s Hospice, Sulaibikhat, Kuwait 2 Sabah Pediatric Hospital, Kuwait City, Kuwait
Vol. 52 No. 6 December 2016
medication was extracted from patient files during the first consultation. Counseling sessions focused on the following: Education regarding drug dosage, administration, treatment, adverse effects, interactions and over or under utilization. Discussion with patients /carers with an emphasizing the importance of adhering to the prescribed drug regime and ensuring that they understand and feel confident to follow the directions provided. Clarifying misconceptions regarding addiction, dependence and tolerance. Managing cessation or dose reduction of long term medications and implications for psychological and physiological harm. Balancing benefits and risk in the context of a changing clinical picture Ensuring medications remain appropriate Maximizing the patient’s period of functional independence. Following the consultation, post counselling medication review was achieved by completing the medication record chart. Results: Seven cases (oncological N¼ 6 and hematological N¼ 1) were referred to the hospice pharmacist. Follow-up visits revealed care taker adherence to medication improved in each case. Positive testimonials from carers who were previously reluctant to use opioids described improvements in physical symptoms and quality of life. Best pharmaco-therapeutic solutions were identified further. Conclusion: High quality PPC requires both traditional and expanded pharmacist services as they can contribute to positive outcomes of pharmacotherapy. In my experience in hospice care, pharmacological counselling is a key approach to treatment modality in symptoms management. Continuous education and counselling is fundamental for the patients and families to improve their drug compliance.
1
Objectives: Adherence to beneficial drug therapy is an essential component in improving and maintaining quality of life in PCC patients. The aim was to examine the role of the hospice pharmacist in improving adherence and knowledge about pharmacotherapy in PPC patients referred to hospice. Methods: Hospice patients with a history of suboptimal medication adherence and non-compliance were referred for a pharmacy consultation with the hospice pharmacist between Jan-Dec 2015. History of
P256 The Spiritual Impact of a Life-Limiting Diagnosis In-Utero
Sarah Meaney1, Daniel Nuzum2,3, Keelin O’Donoghue2,3 1 National Perinatal Epidemiology Centre, University College Cork, Ireland 2 University College Cork, Cork, Ireland 3 Cork University Maternity Hospital, Cork, Ireland
The diagnosis of a life-limiting condition in-utero is a devastating experience for parents and their wider family. Parents begin the process of grieving before