Hospice is a comprehensive program of care for patients facing a life-limiting illness or injury. Patient care involves a team-oriented approach to medical care, pain management, and emotional and spiritual support. Hospice emphasizes palliative care (not curative treatment) with an individualized plan of care for each patient. The goal of hospice is to improve quality, rather than quantity, of life.
Medications and Hospice
Caring for a hospice patient often involves providing medications to relieve pain and manage symptoms. However, effects from long-term illness may limit the ability to continue giving the same medications the patient is used to taking. Over time, the body changes in response to chronic, long-term illness. Medications that used to be helpful for the patient may no longer provide the same benefit.
Patients may become tolerant to the medications they have been taking for a long period of time. For example, a patient who takes opioid pain relievers will eventually need higher doses given more often throughout the day because he/she will develop tolerance to them. As the dose continues to increase, the medication may no longer be appropriate to use. Also, with increasing dosages, the number of pills to be taken each day increases, which may not be acceptable or manageable for the patient.
An alternate method for providing medications is often needed in hospice care. The patient may become unwilling or unable to swallow oral medications (tablets or capsules). Patients with GI tract complications are often unable to process medications correctly, which may lead to uncontrolled symptoms or intolerable side effects. These patients need more medication options because commercially available medications may not provide the strength or dosage form required for an individual patient. Dosing should be individualized, based on body size and composition, various organ failures, and drug tolerance.
How can the Medicine Shoppe help you?
Each individual has unique needs, especially when he/she is under hospice care. We will work with you and your physician to design a customized medication to satisfy your specific needs. Compounding, or preparing customized medications, offers more treatment options to relieve pain, control symptoms, and provide the best quality of life in hospice. We can provide alternative dosage forms that will be easier for you, or your loved one, to use during this difficult time.
In hospice, compounded medications are useful for the following:
•Shortness of breath or chronic obstructive pulmonary disease (COPD)
•Nausea and vomiting
•Restlessness and agitation
•Cachexia (weight loss)
•Oral/esophageal tissue damage (from chemotherapy or radiation treatment)
•Seizure control and maintenance
We can make several forms of medications to suit your hospice needs, including liquids, creams, ointments, gels, sprays, lotions, suppositories, and powders. Our goal is to tailor your medication therapy in order to keep administration of medication to a minimum. Unique combinations can be prepared which contain multiple medications in a single dosage form. Commercially available medications may not provide the exact strength your loved one needs to control his/her symptoms. Compounding these medications gives us the ability to adjust medication strengths to achieve the most appropriate dose for the patient.
With each compounded prescription, we provide detailed education about how to use the medication and techniques that may be helpful to make administration easier. If you have questions regarding your compounded prescription, please call one of our pharmacists.
Resources for Patients and Caregivers
1.National Hospice and Palliative Care Organization. www.nhpco.org
2.Professional Compounding Centers of America (PCCA): Hospice Compounding. Available from: http://www.pccarx.com/what-is-compounding/specialty-compounding/hospice-compounding/.