Role of dispensing pharmacists in home palliative care, impact on their well-being and psychological adjustment factors

Home is the preferred environment for people at the end of life: seventy percent of individuals still reside at home 30 days before their death, even though the hospital most often welcomes them in the very last days of life (Observatoire National sur la Fin de Vie, 2013). As long as patients remain at home, dispensing pharmacists are a valuable resource for families. These professionals are available for their patients, they know the drugs and their effects, and they can travel to the home to install the equipment needed for comfort care. Particularly in areas with medical deserts, pharmacists sometimes become the frontline healthcare professionals to whom loved ones turn for support (Aubry & Van Lander, 2019).

The exact role of dispensing pharmacists in home palliative care nevertheless remains poorly understood in the scientific literature. A meta-analysis of the international literature (Gaillardet, 2019) reveals that only 7 quality studies have been published on this topic, and none of them concern France. In addition, numerous studies have already examined the psychological impact of regular confrontation with suffering and death among healthcare professionals (mainly nurses and doctors) (Melvin, 2015; Slocum-Gori, Hemsworth, Chan, Carson, & Kazanjian, 2013; O'Mahony, Gerhart, Grosse, Abrams, & Levy, 2016). In particular, these studies have established the presence among professionals of symptoms of post-traumatic stress, burn-out, empathic distress, compassion fatigue, anxiety or depression, but also more positive signs such as compassionate satisfaction. To our knowledge, however, none of these studies has so far involved dispensing pharmacists. Just like other caregivers, these professionals are at risk of vicariously suffering from repeated experience of distress and death, especially as few pharmacists have received specific training in palliative care. This thesis work will seek to fill this scientific gap by studying the role of dispensing pharmacists in home palliative care, analyzing the psychological impact of this experience on professionals, and researching the psychological adjustment factors implemented by these individuals throughout their professional experience.

Thesis defended May 19, 2025, under the supervision of Michael DAMBRUN and Axelle MANEVAL VAN LANDER

Link to theses.fr: https://theses.fr/s363049