Palliative medicine utilizes a multidisciplinary approach to patient care. Pharmacists and dispensers are part of the palliative care team, and are responsible for provision of medical therapy which is the cornerstone of most, but not all symptom control in palliative care.
One of the many symptoms treated in palliative care is pain, which is often treated with morphine. We noticed that it was sometimes difficult to access morphine within the hospital. We further recognized that although pharmacists are integral to the provision of morphine and other aspects of palliative medicine, palliative care was unfortunately not included within their curriculum. We spoke to the head of pharmacy who was very keen for the pharmacists to participate in the training and, as a result, we worked together to create the first ever training for pharmacists in palliative care in Mulago Hospital.
The aim of the training was to increase understanding of the concept and principles of palliative care as well as dispel fears and myths about opioids, so that the pharmacists could effectively and actively participate in palliative care. This would be done through formal teaching and a clinical session modeling good practice. We hoped to enhance team work between the pharmacy teams, the palliative care teams, and other healthcare workers, and therefore to optimize the quality of care for patients and their family with life limiting illnesses.
Pharmacists and dispensers from different wards across the hospital and the cancer institute were identified and trained as link pharmacist/dispensers. They all took part in five half day classroom training sessions as well as one half day clinical placement within the Makerere Palliative Care Unit (MPCU) team. These sessions were provided by the Institute for Hospice and Palliative Care in Africa (ihpca) and Mulago Palliative Care Unit. Fifty-five intern pharmacists and dispensers have been trained in these sessions so far. This has been really successful; as a result, there is a plan to have ongoing pharmacist training in Mulago Hospital and we are currently discussing implementing palliative care even in the pharmacist undergraduate curriculum.
The effect of this training can be demonstrated in some of the quotes given by some of those who participated:
“Palliative care was a mystery to me but I have realized that it is very important to every health worker.”
“The course made a change in my perspective in the relationship between spirituality and therapeutic care.”
“I learnt the perception I had on morphine as being addictive was wrong.”
“The training was an eye opener into what takes place in palliation, role of the pharmacist in palliation. I appreciate the opportunity I was awarded with to join the programme and recommend for it to be part of the training for all medical workers if possible.”
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