Literature Review

The role of an inpatient hospice and palliative clinical pharmacist in the interdisciplinary team Texas Medical Center Documents, published by the American Journal of Hospice and Palliative Medicine; by Jetavia Jones Moody, Ivy O. Poon, and Ursula K. Braun; 6/30/25 Palliative care is a specialized health care service for individuals with serious illness at any stage and can be provided in any setting. Current national consensus developed by palliative care experts recommends the inclusion of pharmacists in an interdisciplinary team (IDT) to provide quality palliative care. However, national registry data report that less than 10% of inpatient palliative teams in the U.S. have a clinical pharmacist. Clinical pharmacists have an impactful role in palliative patients' quality of life by optimizing symptom management, deprescribing, and providing education to the palliative care team as well as patients and their families. 

Leading PBMs face increasing scrutiny from statesHealthcare Brew; by Nicole Ortiz; 6/18/25Iowa is the latest to impose limits on how PBMs can operate in the state... It all started when Arkansas Governor Sarah Huckabee Sanders signed a law on April 16 saying any company that owns a pharmacy benefit manager (PBM) would be prohibited from also owning or operating pharmacies in the state. That’s seemingly bad news for the Big 3 PBMs—Cigna Group’s Express Scripts, CVS’s Caremark, and UnitedHealth’s Optum Rx, which collectively control nearly 80% of the market—seeing as they all also operate pharmacy chains. Now the state of Iowa wants to get in on the action, with Governor Kim Reynolds signing a law on June 11 to change how PBMs operate in the state.

Dr. Anne Merriman obituary: doctor known as ‘mother of palliative care in Africa’ The Times, London, England; 6/18/25 Dr. Anne Merriman revolutionised palliative and end-of-life care in Africa after developing a cheap form of oral morphine with a Singapore hospital pharmacist. ... Universally known as “Dr. Anne”, she said: “It’s easier than baking a cake.” She developed the pain-controlling recipe after seeing terminally ill patients discharged from hospital because “nothing more could be done for them”. Many died at home in severe and prolonged pain. “A wild, undisciplined schoolgirl” who became a nun and a doctor, Merriman founded the pioneering Hospice Africa Uganda (HAU) in 1993 at the age of 57. Palliative care was largely unknown in Africa when she started her work in Uganda. HAU has treated more than 35,000 patients and trained more than 10,000 healthcare professionals from 37 African countries in the so-called Merriman model. ... Anne Merriman, doctor, was born on May 13, 1935. She died from respiratory failure on May 18, 2025, aged 90.

MLN Fact Sheet: Creating an efffective Hospice Plan of CareCenters for Medicare & Medicaid Services, Medicare Learning Network (MLN); 5/10/25 The hospice plan of care (POC) maps out needs and services given to a Medicare patient facing a terminal illness, as well as the patient’s family or caregiver. CMS data shows that some hospice POCs are incomplete or not followed correctly. This fact sheet educates on creating and coordinating successful hospice POCs. The primary goal of hospice care is to meet the holistic needs of an individual and their caregiver and family when curative care is no longer an option. To support this goal:

Spouses accused of prescription fraud: Nurse took meds from hospice patients, deputies say The Daily Record; by Staff; 5/22/25 A hospice nurse and her husband are accused of diverting and trafficking controlled prescription medications from several pharmacies during her employment at Liberty Home Health and Hospice. Juana Nicole Hull, 42, is charged with six counts of conspiring to traffic opium or heroin and four counts each of obtaining a controlled substance through fraud; embezzling or diverting a controlled substance; and trafficking opioids. Her husband, 38-year-old Robert Wayne Hull, is charged with six counts each of obtaining a controlled substance through fraud and trafficking opioids. 

New Mexico legalizes medical use of psilocybin JD Supra; by Patrick Clark and Jennifer Pacicco; 5/20/25 On April 7, 2025, New Mexico became the third state to legalize psilocybin (colloquially known as “magic mushrooms” or “shrooms”) for medical purposes. New Mexico is the first state to legalize psilocybin via legislation and not a ballot initiative, like its predecessors Colorado and Oregon. Under the new law—the “Medical Psilocybin Act”—the following qualifying conditions are listed as eligible for psilocybin treatment: “(1) major treatment-resistant depression; (2) post-traumatic stress disorder; (3) substance use disorders; (4) end-of-life care.” The law also allows the New Mexico Department of Health to promulgate regulations that would add qualifying conditions to that list. ... Employers are not required to accommodate employees under the influence of psilocybin at work.

Pharmacist-led care in palliative settings: Using anticholinergics thoughtfully and compassionately Pharmacy times; by Diana Violanti, PharmD, Pamela S. Moore, PharmD, BCGP, and Alana Hippensteele; 5/5/25 The use of anticholinergic agents to manage terminal secretions, often referred to as the death rattle, remains a nuanced and evolving area of end-of-life care. While these medications are frequently used in hospice and palliative care settings to reduce secretion-related sounds that may be distressing to caregivers, their efficacy in improving patient comfort is less clear and often debated. ... Diana Violanti, PharmD, and Pamela S. Moore, PharmD, BCGP, discuss the nuanced use of anticholinergic agents for managing terminal secretions at end of life, highlighting practical considerations, timing, safety concerns such as delirium, and the limited yet evolving evidence supporting their role in palliative care.

Breaking barriers: Ketamine's  role in hospice medicine with Dr. Rohini Kanniganti Teleios Collaborative Network (TCN); podcast by Chris Comeaux with Dr. Rohini Kanniganti; 4/30/25 Ketamine – a medicine long used as an anesthetic – is finding a powerful new purpose in Hospice and Palliative Care settings.  Dr. Rohini Kanagante, a physician with expertise spanning both Hospice Care and Integrative Psychiatry, unveils the remarkable potential of this medication in our latest episode of TCNtalks. [TCN is a sponsor of our newsletter.]

Dr. Drabek's "The Comfortologist" hits #1 bestseller, revolutionizing pain management & end-of-life care approaches Classic 96.7 FM BWZ, Yukon, OK; Press Release; 4/28/25 Dr. Steven Drabek's groundbreaking memoir, "The Comfortologist: A Physician's Empathetic Perspective on Compassion, Caring, and Pain Relief," has achieved #1 bestseller status, resonating deeply with healthcare professionals, chronic pain patients, and families navigating end-of-life care decisions. Drawing from his four-decade career and personal journey as a cancer survivor and chronic pain patient, Dr. Drabek offers readers a unique dual perspective that has earned him recognition as a "comfortologist" a term he coined to describe his approach to medicine that prioritizes patient comfort and dignity. "My experience as both physician and patient taught me that modern medicine often misses what matters most," says Dr. Drabek. "Technical expertise means little without empathy. We must treat the whole person, not just the symptoms."

Walgreens will pay up to $350M in settlement with DOJ to resolve opioid prescription lawsuit Fierce Healthcare; by Heather Landi; 4/21/25 Walgreens has agreed to pay $300 million to settle allegations from federal prosecutors that it illegally filled millions of invalid prescriptions for opioids and other controlled substances, the Department of Justice (DOJ) announced Monday. The DOJ also alleges that the retail pharmacy chain sought payment for many of those "invalid" prescriptions by Medicare and other federal healthcare programs in violation of the False Claims Act. The settlement amount is based on Walgreens’s ability to pay, the DOJ said, but Walgreens will owe the U.S. an additional $50 million if the company is sold, merged or transferred prior to fiscal year 2032. 

Using technology to improve matching drug details in hospice care Patient Safety & Quality Healthcare (PSQH); by Matt Phillion; 4/17/25 For Wise Hospice Options, prescribers had been spending an average of 15 seconds matching each flagged drug and 20 seconds per drug entering missing sig, or label, details. Recently, they incorporated clinical-grade AI from DrFirst into automating this process, enabling those same providers to spend two to three seconds per drug, with fewer medications flagged for manual review by pill icons. ... The AI implementation allowed Wise to standardize data from different systems into a workflow that allows clinicians to see complete information before ordering prescriptions, helping avoid delays and reduce errors. Clinicians continue to review medication information for accuracy and adjust based on discussions with the patient but require fewer clicks and keystrokes so they can make faster, more informed decisions. ... Why the impact on hospice is key: The first thing to consider, Faubion explains, is that when it comes to hospice patients, they are going to be on a lot of medications. ...

More than just meds: What a palliative care pharmacist learned from the bedside Pharmacy Times; by Trinh Bui, PharmD, Yale New Haven Health; April 2025 Issue A palliative care pharmacist highlights a spectrum of clinical opportunities for patients, caregivers, and clinicians when rounding at the bedside. ... I hold a unique clinical position. In 2018, the National Palliative Care Registry reported that less than 10% of national palliative care (PC) programs have a dedicated pharmacist. I am a member of the PC consultation service at a cancer hospital affiliated with a large tertiary academic medical center in New Haven, Connecticut. Routinely, we are consulted for at least 40 patients a day, with more than 2000 consults in 2024. ... A benefit of having a clinical pharmacist on the interdisciplinary team includes the ability to provide off-label medication to optimize complex medication regimens while honoring patients’ psychosocial, cultural, and spiritual needs. ...