Medications are frequently used to treat pain and other symptoms associated with advanced illnesses. It is critically important that hospice and palliative care practitioners excel in all three steps in this medication management process. This includes scrupulous attention to medication reconciliation and a comprehensive medication regimen review with particular attention to the changing goals of care. Medicare regulations require that hospice programs confer with an individual with education and training in drug management to prevent, detect, and resolve drug-related problems.
Copyright: 2014Continuing Education: No CME availableFormat: Available only as MP3 download
Medications are frequently used to treat pain and other symptoms associated with advanced illnesses. It is critically important that hospice and palliative care practitioners excel in all three steps in this medication management process. This includes scrupulous attention to medication reconciliati...
Examples include over- or underdosage, adverse effects, inappropriate drug selection, untreated indications, drug use without indication, and nonadherence. Once the medication regimen is honed to specifically target the patient’s therapeutic goals at this critically important time in their life, a decision must be made regarding which medications the hospice program should provide. Medicare guidelines state that drugs related to the palliation and management of the terminal illness and related conditions be provided by the hospice. However, this requirement is often interpreted with great disparity, both in terms of which medications are related to the terminal illness and in particular what constitutes a related condition, and, consequently, the medications that should be used to palliate symptoms for related conditions.
Further complicating the situation are those patients who are admitted on medications that may be related to the terminal diagnosis or a related condition, but for which there is no evidence to substantiate their use at that point. Another example is the use of prohibitively expensive medications when cost-effective medications are available. This session is designed to review these requirements from Medicare and to use a case-based approach for decision making in the medication management process. This is a critically important discussion for every hospice and palliative care practitioner, aimed at ensuring equity for all parties (the patient, the hospice and Medicare) and successful therapeutic outcomes for our patients.