Mapping the evidence against the Daffodil Standards for the developing role of community pharmacists in palliative care: a systematic scoping review

Problem

Palliative care is a growing field of medicine that is always looking for ways to develop in order to provide the best care for patients. Following the development and the implementation of the Daffodil standards created for General Practice, these standards are now being designed specifically for community pharmacists delivering palliative care. Community pharmacists have been recognized as having a key role in palliative care due to the access they have to resources and contact time with patients within their homes. This scoping review aims to map evidence against the Daffodil Standards for the developing role of community pharmacists in palliative care.

Approach

A search strategy including keywords such as palliative care, terminal care, end-of-life, hospice care, pharmacies, and community pharmacists was designed, tested, and applied to search seven electronic databases (Medline, EMBASE, EMCARE, PsycINFO, Scopus, Cochrane Library, CINAHL) and 12 relevant websites. The articles collected from the electronic databases and the grey literature were also cross-referenced with a document from the HDAS database that had articles relating to community pharmacists and palliative care to see if there were any more relevant articles that may have been missed from the initial search. Included studies i) refer to ‘palliative care’ or ‘last days’ or ‘end of life’ care, ii) relate to the role of community pharmacists, iii) are published in English, and iv) are from OECD countries. No date or study design constraint was used. Two reviewers independently reviewed the title and abstracts of each source; a third reviewer accessed any disagreements. The key concepts initially discussed were taken into consideration and helped guide the initial screening of the articles and the design of the data abstraction form.

Findings

A total of 1029 records were identified, after removing duplicates and irrelevant records a total of 724 abstracts were screened, from these, 115 full-text articles were assessed for eligibility. Data from 45 articles are being extracted and, themes and subthemes are mapped against the Daffodil Standards for GPs. Full findings will be presented at the conference.

Consequences

Palliative care is increasingly delivered in the community setting, and the capillary presence of community pharmacies makes the pharmacist the ‘first port of call’ when seeking health advice. The community pharmacist is now an established member of the primary care team and has much to offer to patients diagnosed with a terminal illness or in end-of-life care due to frailty and their families. This scoping review has been designed to acknowledge the current role of a community pharmacist and how this role can be further extended to improve wider and fairer access to palliative care services.