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Abstract

Adequate pain and symptom management is an essential component of palliative and end-of-life care and has a direct impact on patient and caregiver experience. In September 2014, the Champlain CCAC, in collaboration with regional pharmacies, service provider organizations, the Regional Palliative Consultation Team and community palliative care physicians, introduced a Champlain Wide Pain and Symptom Management Kit (SMK). The SMK is a standard package of medications and related medical supplies placed in the home of a patient who is approaching the end-of-life for the purpose of relieving unanticipated or rapidly escalating symptoms in a timely manner. The overall purpose of the Kit is to facilitate pain and symptom management at the end of life by providing timely access to medications and supplies, therefore optimizing patients� chances of remaining at home until death; enhancing informal caregiver support in the home; and enabling nurses to manage symptoms without needing immediate access to a physician, which is often difficult. One year after implementation, a robust evaluation was completed. The results demonstrate a positive impact of the Kit on patients, caregivers, and provider experience, including reduction of caregiver anxiety and increased self-efficacy. The results also demonstrate a positive impact on a number of outcome measures, such as reduced emergency department visits and hospital admissions, and increased patient deaths in their preferred location.

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