Precision Pharmacopalliation: A No-Nonsense, Boots-on-the-Ground Approach to Medication Management at the End of Life (P05)

Abstract

•Recognize discriminating history, physical exam, and other information that drives drug-therapy decision-making designed to treat the complaint of pain or one of the top ten nonpain symptoms.•Select medications that reflect consideration of patient- and drug-related variables.•Recommend an appropriate starting dose, titration schedule, and plan for discontinuing therapy.•Describe three strategies in medication selection that will make for a smooth transition. To be successful, this will include recommending discontinuation of futile medications and selecting specific medications that are user-friendly in hospice care. Patients experiencing advanced, life-limiting illnesses frequently require drug therapy to achieve symptom control. However, it is imperative that medications are selected with meticulous care and attention to both patient- and medication-related variables. Participants in this highly practical, fast-paced session will learn how to consider a discriminating history, physical exam, and other information that will result in selection of the best medications that deliver the most benefits with the least burden. Participants will learn the specifics of not only how to select medications but also how to initiate dosing and titration strategies (amount of drug and how quickly) and how to discontinue medications (titration down or abrupt stop). This session is designed for both hospice and palliative care practitioners and will deliver on the promise of how to make drug therapy decisions that ensure smooth transitions in care. This will include patients who transition from home-based hospice to inpatient palliative care and vice versa and how palliative care teams can initiate drug therapies that ensure seamless transition to hospice. Participants will leave this session with a bag full of tips and strategies they can implement the next day back on the job.