This scenario presents a professional challenge because it requires a pharmacist to navigate the specific requirements and intent behind the Applied Latin American Palliative Care Pharmacy Competency Assessment. Misunderstanding the purpose or eligibility criteria can lead to wasted resources, delayed professional development, and potentially compromise patient care by not ensuring adequately trained personnel are available. Careful judgment is required to accurately interpret the assessment’s objectives and who it is designed to serve. The correct approach involves a thorough review of the official documentation outlining the purpose and eligibility for the Applied Latin American Palliative Care Pharmacy Competency Assessment. This includes understanding that the assessment is specifically designed to evaluate the specialized knowledge and skills of pharmacists practicing or intending to practice in palliative care within the Latin American context. Eligibility is typically tied to demonstrated experience, specific training in palliative care, and often a commitment to serving patient populations in Latin America. Adhering to these defined criteria ensures that the assessment serves its intended function of standardizing and validating competency in this niche area of pharmacy practice, thereby promoting quality palliative care. An incorrect approach would be to assume the assessment is a general palliative care competency evaluation applicable to any region or practice setting. This fails to recognize the specific geographical and contextual focus of the “Latin American” designation, which implies consideration of regional healthcare systems, common palliative care challenges, and relevant cultural nuances within Latin America. Such a broad interpretation would undermine the assessment’s purpose of addressing specific regional needs and standards. Another incorrect approach would be to believe that simply having a general pharmacy license and some exposure to palliative care patients is sufficient for eligibility. The assessment is designed for a higher level of specialized competency. Without meeting the specific experience or training prerequisites, a pharmacist would not possess the depth of knowledge and skills the assessment aims to verify, leading to an inappropriate application and a misrepresentation of their readiness. Furthermore, assuming the assessment is a prerequisite for any pharmacist seeking to gain basic palliative care knowledge is also flawed. The assessment is not an introductory course; it is a competency evaluation for those already engaged in or preparing for specialized palliative care practice. Using it as a foundational learning tool bypasses the intended process of building foundational knowledge through education and experience before seeking formal competency validation. The professional reasoning framework for pharmacists in such situations should begin with a commitment to understanding the precise objectives and scope of any professional assessment. This involves actively seeking out and meticulously reviewing official guidelines, regulatory documents, and assessment frameworks. When faced with ambiguity, consulting with professional bodies, assessment administrators, or experienced colleagues in the relevant specialty is crucial. The decision-making process should prioritize alignment with the assessment’s stated purpose and eligibility criteria to ensure both personal professional development and the integrity of the competency validation process.

The assessment process reveals a common challenge in palliative care pharmacy: ensuring patient-centered care while adhering to evolving professional standards and ethical considerations. This scenario is professionally challenging because it requires balancing the pharmacist’s direct patient interaction and clinical judgment with the need for clear, documented communication and collaboration within the interdisciplinary team. The inherent vulnerability of palliative care patients necessitates a high degree of trust and transparency, making any deviation from best practices potentially detrimental to their well-being and the integrity of the healthcare system. Careful judgment is required to navigate the nuances of patient autonomy, family involvement, and the pharmacist’s evolving role. The best approach involves proactively seeking clarification and confirmation from the prescribing physician regarding the patient’s current medication regimen and any perceived discrepancies, while simultaneously documenting these interactions and the rationale for any proposed adjustments. This aligns with the fundamental ethical principle of beneficence, ensuring the patient receives appropriate and safe care. It also upholds the professional responsibility of pharmacists to exercise independent judgment and to communicate effectively with other healthcare professionals to optimize patient outcomes. Regulatory frameworks in Latin America, while varying by country, generally emphasize the pharmacist’s role in medication safety and collaboration, requiring pharmacists to verify prescriptions and to engage in rational drug therapy management. This approach ensures that any changes are based on sound clinical reasoning and are sanctioned by the prescriber, thereby minimizing the risk of error and promoting continuity of care. An approach that involves unilaterally adjusting the patient’s medication based on the pharmacist’s interpretation of the patient’s needs, without direct physician consultation, fails to uphold the principle of professional collaboration and can lead to medication errors or adverse drug events. This bypasses the established hierarchy of prescribing authority and undermines the collaborative nature of patient care, potentially violating professional guidelines that mandate physician oversight for prescription modifications. Another unacceptable approach is to simply document the perceived discrepancy without taking any further action or seeking clarification. This passive stance neglects the pharmacist’s duty of care and the responsibility to ensure medication safety. It allows a potential issue to persist, which could negatively impact the patient’s palliative care experience and potentially lead to harm, failing to meet the standards of proactive pharmaceutical care. Furthermore, an approach that involves discussing the perceived discrepancy with the patient’s family without first consulting the physician or obtaining explicit consent for such a discussion is ethically problematic. While family involvement is often crucial in palliative care, direct medical advice or prescription-related discussions should primarily occur between the healthcare team and the patient, or with explicit authorization. This can create confusion, undermine the physician’s authority, and potentially lead to misinterpretations of the treatment plan. The professional reasoning framework for such situations should involve a systematic process: 1) Identify the potential issue (e.g., perceived medication discrepancy). 2) Assess the potential impact on the patient. 3) Consult relevant professional guidelines and ethical principles. 4) Initiate clear and direct communication with the prescribing physician to seek clarification and propose solutions. 5) Document all interactions and decisions meticulously. 6) If necessary, involve other members of the interdisciplinary team. This structured approach ensures that patient safety and well-being remain paramount while adhering to professional and regulatory expectations.

Scenario Analysis: This scenario is professionally challenging because it requires the pharmacist to integrate complex clinical pharmacology principles with the specific pharmacokinetic profiles of a vulnerable patient population receiving palliative care. The integration of medicinal chemistry knowledge is crucial for understanding drug interactions and optimizing therapeutic outcomes while minimizing adverse effects, all within the context of a patient experiencing significant physiological changes and potentially multiple comorbidities. The ethical imperative to provide the highest standard of care, respecting patient autonomy and dignity, adds another layer of complexity. Correct Approach Analysis: The best professional practice involves a comprehensive review of the patient’s current medication regimen, considering the specific pharmacokinetic and pharmacodynamic properties of each drug in the context of their palliative care needs and potential organ dysfunction. This includes evaluating potential drug-drug interactions, drug-disease interactions, and the impact of altered metabolism and excretion on drug efficacy and toxicity. The pharmacist should then collaborate with the prescribing physician and the patient (or their surrogate decision-maker) to propose evidence-based adjustments to the regimen, prioritizing symptom control, quality of life, and minimizing polypharmacy, all while adhering to established palliative care guidelines and ethical principles of beneficence and non-maleficence. This approach directly addresses the integration of clinical pharmacology, pharmacokinetics, and medicinal chemistry to achieve optimal patient outcomes. Incorrect Approaches Analysis: One incorrect approach would be to solely focus on the prescribed dosages without considering the patient’s altered pharmacokinetic profile due to their palliative care condition. This fails to acknowledge how changes in renal or hepatic function, common in this population, can significantly impact drug absorption, distribution, metabolism, and excretion, potentially leading to sub-therapeutic effects or toxicity. This neglects fundamental principles of clinical pharmacology and pharmacokinetics. Another unacceptable approach would be to recommend discontinuing medications based on a superficial understanding of potential side effects without a thorough pharmacokinetic assessment or consideration of the drug’s role in symptom management. This overlooks the intricate balance required in palliative care, where medications are often used to alleviate suffering, and a hasty discontinuation could worsen the patient’s condition. It demonstrates a lack of medicinal chemistry understanding regarding drug mechanisms and interactions. A further incorrect approach would be to rely solely on generic drug information resources without cross-referencing with specific literature relevant to palliative care and the patient’s particular clinical presentation. This can lead to outdated or inappropriate recommendations, failing to account for the nuanced application of pharmacotherapy in this specialized field and potentially violating ethical obligations to provide current and accurate advice. Professional Reasoning: Professionals should adopt a systematic approach that begins with a thorough patient assessment, including their medical history, current medications, and the specific goals of care. This should be followed by a critical evaluation of the pharmacological properties of each medication, considering pharmacokinetic and pharmacodynamic principles, especially in the context of the patient’s physiological state. Collaboration with the healthcare team and open communication with the patient are paramount. Decision-making should be guided by evidence-based practice, ethical considerations, and a commitment to patient-centered care, ensuring that all interventions are aimed at maximizing benefit and minimizing harm.

Scenario Analysis: This scenario presents a professional challenge in a Latin American palliative care pharmacy setting where the availability of specific excipients for compounding sterile products is limited. Ensuring the quality, safety, and efficacy of compounded medications under resource constraints requires meticulous adherence to pharmaceutical standards and ethical considerations, particularly when dealing with vulnerable patients receiving palliative care. The pharmacist must balance the immediate need for a medication with the long-term implications of product integrity and patient safety. Correct Approach Analysis: The best professional practice involves a thorough investigation into the suitability of the available alternative excipients. This includes consulting reputable pharmaceutical formularies, scientific literature, and potentially contacting the manufacturer of the original excipient for guidance on acceptable substitutions. The pharmacist must assess the compatibility of the alternative excipient with the active pharmaceutical ingredient, its impact on the stability and sterility of the final product, and any potential for increased toxicity or reduced efficacy. If a suitable alternative is identified and validated, the compounding process can proceed with appropriate documentation and quality control measures. This approach prioritizes patient safety and product integrity by ensuring that any deviation from the standard formulation is scientifically justified and rigorously controlled. Incorrect Approaches Analysis: One incorrect approach would be to proceed with compounding using the alternative excipient without any validation or investigation into its suitability. This is professionally unacceptable because it bypasses essential quality control steps, potentially leading to the administration of a compromised medication. The lack of scientific justification for the substitution poses a significant risk to patient safety, as the alternative excipient could interact negatively with the active ingredient, affect the drug’s stability, or introduce new toxicological concerns. Another incorrect approach would be to inform the prescriber that the medication cannot be compounded due to the unavailability of the specific excipient and to cease all efforts to find a solution. While patient safety is paramount, this approach fails to explore all reasonable avenues to meet the patient’s needs. In a palliative care setting, timely access to medication is often critical, and a complete cessation of compounding efforts without exploring alternatives demonstrates a lack of professional initiative and commitment to patient care. A third incorrect approach would be to use an excipient that is commonly used in non-sterile preparations without considering its suitability for sterile compounding. Excipients approved for non-sterile dosage forms may not meet the stringent requirements for sterility, pyrogenicity, or particulate matter necessary for injectable or other sterile products. Using such an excipient would violate fundamental principles of sterile product preparation and compromise the safety and efficacy of the compounded medication. Professional Reasoning: Professionals in this situation should adopt a systematic problem-solving approach. First, clearly identify the critical components of the original formulation and the reasons for their inclusion. Second, conduct a comprehensive literature and formulary search for scientifically validated alternatives that meet the required pharmaceutical standards for sterile compounding. Third, if a potential alternative is found, perform or document any necessary compatibility and stability testing. Fourth, maintain meticulous records of all decisions, investigations, and actions taken. Finally, communicate transparently with the prescriber and, where appropriate, the patient about any formulation changes and the rationale behind them. This structured approach ensures that patient care is prioritized while adhering to the highest standards of pharmaceutical practice.

This scenario is professionally challenging because it requires balancing patient safety, the efficient use of limited palliative care resources, and adherence to evolving regulatory expectations for medication management in a specialized setting. The pressure to provide timely and effective pain management, coupled with the inherent risks of polypharmacy and potential drug interactions in palliative care patients, necessitates a robust and compliant approach to medication safety. Careful judgment is required to ensure that informatics systems are not only functional but also actively contribute to preventing errors and meeting regulatory mandates. The approach that represents best professional practice involves proactively integrating pharmacovigilance data and regulatory updates into the electronic health record (EHR) system’s medication management module. This includes establishing automated alerts for potential drug interactions, contraindications based on patient-specific factors (e.g., renal function, age), and adherence to formulary guidelines relevant to palliative care. Furthermore, this approach necessitates regular training for all healthcare professionals on how to interpret and respond to these alerts, as well as a clear protocol for reporting adverse drug events (ADEs) and near misses directly through the EHR. This is correct because it leverages informatics to create a proactive safety net, directly addressing regulatory expectations for medication safety by embedding risk mitigation strategies within the workflow. It aligns with the principles of patient safety and continuous quality improvement by facilitating timely identification and management of medication-related risks. An approach that relies solely on manual chart reviews for medication reconciliation without leveraging EHR capabilities for automated checks fails to fully utilize available technology for error prevention. This method is prone to human error, is time-consuming, and may not catch subtle but critical drug interactions or contraindications that an informatics system could flag. It falls short of regulatory expectations for robust medication safety systems. An approach that prioritizes the immediate availability of any requested medication without a systematic process for verifying its appropriateness and safety in the context of the patient’s overall medication regimen and palliative care goals is ethically and regulatorily unsound. While responsiveness is important, it must be balanced with a thorough safety assessment to prevent iatrogenic harm. This overlooks the regulatory imperative to ensure that medications are prescribed and dispensed safely. An approach that focuses on updating the EHR with new drug information but does not implement corresponding alerts or workflow changes for prescribers and pharmacists misses a critical step in translating data into actionable safety measures. The mere presence of information in the system does not guarantee its effective use for patient safety. Regulatory compliance requires not just data storage but the active application of that data to prevent errors. Professionals should employ a decision-making framework that begins with understanding the specific regulatory requirements for medication safety and informatics in their jurisdiction. This should be followed by an assessment of the current EHR capabilities and limitations. The next step involves identifying potential medication safety risks inherent in palliative care, such as polypharmacy and complex symptom management. The chosen approach should then be evaluated based on its ability to proactively mitigate these risks, integrate seamlessly into clinical workflows, and facilitate compliance with reporting and documentation standards. Continuous evaluation and adaptation of the system based on ADE data and regulatory changes are also crucial.

This scenario presents a professional challenge due to the inherent complexity of managing controlled substances in a palliative care setting, where patient comfort and access are paramount, but diversion and misuse risks must be rigorously mitigated. The pharmacist must balance these competing demands while adhering to strict regulatory requirements and ethical obligations. Careful judgment is required to ensure patient safety, legal compliance, and the responsible stewardship of potent medications. The best professional approach involves a comprehensive review of the patient’s current medication regimen, including a thorough assessment of the prescribed opioid dosage and frequency against established clinical guidelines for pain management in palliative care. This includes verifying the indication for the current dosage, evaluating the patient’s response to treatment, and considering alternative formulations or routes of administration that might improve efficacy or reduce side effects, all while consulting with the prescribing physician to ensure a collaborative and patient-centered decision. This approach is correct because it prioritizes patient well-being and evidence-based practice, aligning with the ethical duty of care and the regulatory framework governing the dispensing of controlled substances, which mandates professional judgment in ensuring appropriate use and minimizing harm. An incorrect approach would be to simply fulfill the refill request without further investigation, assuming the previous prescription was appropriate. This fails to acknowledge the pharmacist’s professional responsibility to monitor medication therapy, assess its ongoing appropriateness, and identify potential issues such as escalating tolerance or the need for dose adjustment. Ethically, this neglects the duty to ensure patient safety and prevent potential harm. Another incorrect approach would be to immediately contact the physician to question the dosage without first conducting an internal review of the patient’s chart and available clinical information. While physician consultation is crucial, a proactive pharmacist should gather relevant data to inform that discussion, demonstrating a commitment to a thorough and evidence-based assessment. This approach could be perceived as an overreach or a lack of independent professional assessment. Finally, an incorrect approach would be to refuse the refill outright due to concerns about the dosage without engaging in a collaborative discussion with the physician or exploring alternative solutions. This could lead to a disruption in essential pain management for a palliative care patient, causing undue suffering and potentially violating the pharmacist’s ethical obligation to facilitate access to necessary medications when clinically appropriate. The professional reasoning framework for such situations should involve a systematic process: 1) Assess the patient’s clinical status and medication history. 2) Review relevant clinical guidelines and regulatory requirements. 3) Identify potential risks and benefits associated with the current therapy. 4) Consult with the prescriber to clarify any concerns and discuss alternative strategies. 5) Document all assessments, consultations, and decisions. 6) Implement the agreed-upon plan, ensuring ongoing monitoring.

The risk matrix shows a moderate likelihood of a candidate misunderstanding the assessment blueprint’s weighting and scoring, leading to potential anxiety and suboptimal preparation. This scenario is professionally challenging because it requires the candidate to navigate the assessment’s structure and policies proactively, rather than reactively. A clear understanding of the blueprint is crucial for effective study planning and managing expectations regarding performance and potential retakes. The best approach involves meticulously reviewing the official assessment blueprint, paying close attention to the stated weighting of each competency domain and the specific scoring methodology. This includes understanding how different question types contribute to the overall score and the minimum passing threshold. Furthermore, it requires a thorough examination of the stated retake policy, including any waiting periods, additional requirements for retaking, and the implications for professional licensure or certification. This proactive and detailed review ensures that preparation efforts are targeted and that the candidate is fully aware of the consequences of their performance, aligning with the ethical obligation to prepare competently and transparently for professional assessments. An incorrect approach would be to rely solely on anecdotal information from colleagues or past candidates regarding the blueprint’s weighting and scoring. This is professionally unacceptable as it introduces a high risk of misinformation, potentially leading to misallocation of study time and inaccurate self-assessment. Such reliance bypasses the official, authoritative source of information and can result in a failure to meet the assessment’s actual requirements. Another incorrect approach is to disregard the retake policy entirely until after the assessment results are known. This demonstrates a lack of foresight and preparedness. The retake policy is an integral part of the assessment framework, and understanding its implications, such as potential delays in professional practice or additional costs, is a professional responsibility. Ignoring it until after a potential failure is a reactive stance that can lead to significant personal and professional disruption. A third incorrect approach is to focus exclusively on the content areas with the highest weighting without considering the scoring nuances or the interdependencies between different domains. While weighting is important, the scoring mechanism might penalize incorrect answers or reward specific types of responses. A comprehensive understanding requires appreciating how all components contribute to the final score, not just the broad topic areas. Professionals should adopt a decision-making framework that prioritizes information gathering from authoritative sources, thorough understanding of assessment policies, and proactive planning. This involves: 1. Identifying all relevant assessment documentation (blueprint, scoring guides, policies). 2. Systematically reviewing each document to understand its implications. 3. Integrating this understanding into a comprehensive study and preparation plan. 4. Anticipating potential outcomes, including the implications of the retake policy.

This scenario is professionally challenging because it requires balancing the candidate’s perceived readiness with the ethical obligation to ensure competence in a specialized area of pharmacy practice. The assessment aims to evaluate a candidate’s preparedness for applied Latin American palliative care pharmacy, a field demanding specific knowledge, skills, and ethical considerations. Careful judgment is required to avoid both underestimating a candidate’s potential and overestimating their preparedness, which could compromise patient safety and the integrity of the assessment. The best professional approach involves a structured, evidence-based evaluation of the candidate’s preparation resources and timeline. This entails a thorough review of the candidate’s self-assessment, their engagement with recommended learning materials (e.g., specific Latin American palliative care guidelines, relevant pharmacotherapy texts, ethical frameworks for end-of-life care in the region), and the duration and nature of their practical experience or simulated practice. The justification for this approach lies in its alignment with principles of competency-based assessment, which emphasize objective evaluation against defined standards. It ensures that preparation is not merely a matter of time spent but reflects meaningful engagement with relevant content and the development of practical skills. This aligns with the ethical imperative to practice pharmacy competently and safely, particularly in a sensitive area like palliative care. An incorrect approach would be to solely rely on the candidate’s self-reported confidence or the length of their study period without verifying the quality or relevance of their preparation. This fails to address the core requirement of demonstrating actual competency. Another unacceptable approach is to dismiss the candidate’s preparation due to a perceived lack of formal, region-specific training if their self-directed learning and experience demonstrate equivalent knowledge and skills. This could be discriminatory and overlook valuable practical experience. Finally, recommending a significantly extended, arbitrary timeline for preparation without a clear rationale based on identified knowledge gaps or skill deficits is unprofessional and inefficient, potentially causing undue delay and frustration for the candidate. Professionals should employ a decision-making framework that prioritizes objective assessment criteria. This involves: 1) clearly defining the competencies required for applied Latin American palliative care pharmacy; 2) evaluating the candidate’s preparation against these competencies using verifiable evidence; 3) identifying specific gaps or areas of strength; and 4) providing targeted feedback and recommendations for further development or assessment, grounded in the evidence gathered.

Scenario Analysis: This scenario presents a professional challenge for a pharmacist in Latin America due to the complex interplay of public health initiatives, the specific needs of a vulnerable population, and the ethical considerations surrounding vaccine access and administration. Ensuring equitable access to immunizations while respecting individual autonomy and adhering to diverse local public health directives requires careful judgment. The pharmacist must navigate potential resource limitations, varying levels of community trust in public health programs, and the need to tailor communication strategies to different cultural contexts within the region. Correct Approach Analysis: The best professional practice involves a proactive, community-centered approach. This entails collaborating directly with local public health authorities to understand current immunization priorities and target populations, such as elderly individuals or those with chronic conditions, and then developing accessible outreach programs. This approach is correct because it aligns with the core principles of public health pharmacy, which emphasizes disease prevention and health promotion at a population level. Specifically, it adheres to the ethical obligation to serve the community’s health needs and the professional responsibility to implement evidence-based public health interventions. By working with authorities, the pharmacist ensures that immunization efforts are aligned with national and regional public health strategies, maximizing impact and resource efficiency. This also respects the regulatory framework that often mandates pharmacist participation in public health campaigns and requires adherence to established protocols for vaccine administration and record-keeping. Incorrect Approaches Analysis: Focusing solely on dispensing vaccines to individuals who present with prescriptions, without active community engagement or collaboration with public health bodies, is an insufficient approach. This fails to address the broader population health impact and may miss opportunities to reach underserved or hesitant groups, thereby undermining the public health objective of widespread immunization. It neglects the pharmacist’s role as a public health advocate and can lead to disparities in vaccine coverage. Another incorrect approach is to prioritize only the most profitable or easily accessible vaccination services, such as those offered in private clinics, without considering the needs of lower-income or geographically isolated communities. This approach is ethically flawed as it creates barriers to access for vulnerable populations and exacerbates health inequities, contradicting the principle of distributive justice in healthcare. It also fails to leverage the pharmacist’s unique position within the community to address public health challenges comprehensively. Finally, implementing immunization programs without clear communication and consent processes tailored to the cultural nuances of the local population is problematic. This can lead to mistrust, low uptake, and potential ethical breaches related to informed consent. It overlooks the importance of culturally sensitive health education and community engagement, which are crucial for the success of any public health initiative. Professional Reasoning: Professionals should employ a decision-making framework that begins with identifying the public health objective (e.g., increasing vaccination rates for a specific disease). This should be followed by an assessment of the target population’s needs, barriers to access, and existing community resources. Collaboration with public health agencies and community leaders is paramount to ensure alignment with broader strategies and to gain community trust. Pharmacists should then design and implement interventions that are accessible, culturally appropriate, and ethically sound, with a strong emphasis on informed consent and patient education. Continuous evaluation of the program’s impact on population health metrics is also essential for refinement and improvement.

The control framework reveals a complex scenario involving a palliative care patient with a rare chronic disease requiring careful therapeutic management. This situation is professionally challenging due to the inherent uncertainties of rare diseases, the potential for polypharmacy in palliative care, the need for individualized treatment plans, and the ethical imperative to prioritize patient well-being and quality of life. Careful judgment is required to balance efficacy, safety, and patient preferences within the available evidence base. The best professional approach involves a comprehensive assessment of the patient’s current condition, disease trajectory, and treatment goals, followed by a collaborative decision-making process with the patient and their caregivers. This includes a thorough review of existing literature on the rare disease, consultation with specialists if necessary, and consideration of off-label uses of medications with appropriate risk-benefit analysis. The chosen therapeutic strategy must be evidence-informed, patient-centered, and regularly re-evaluated for effectiveness and adverse effects. This aligns with ethical principles of beneficence, non-maleficence, and respect for autonomy, and is supported by general principles of good pharmaceutical practice that emphasize individualized patient care and the responsible use of medicines. An incorrect approach would be to solely rely on standard treatment protocols for more common conditions, neglecting the specific nuances of the rare disease and the patient’s palliative care needs. This fails to acknowledge the limitations of generalized guidelines and could lead to suboptimal or harmful treatment. Another incorrect approach would be to avoid any therapeutic interventions due to a lack of definitive evidence for the rare disease, potentially compromising the patient’s comfort and quality of life, which is contrary to the goals of palliative care. Furthermore, making unilateral treatment decisions without involving the patient or their caregivers disregards the principle of patient autonomy and can lead to mistrust and non-adherence. Professionals should employ a decision-making framework that begins with a thorough understanding of the patient’s unique situation. This includes gathering information about the disease, the patient’s values, and their support system. Next, they should identify potential therapeutic options, considering both established and emerging treatments, and critically evaluate the evidence for each. This should be followed by a discussion of these options with the patient and their caregivers, facilitating shared decision-making. Finally, the chosen plan should be implemented with ongoing monitoring and a willingness to adapt the treatment as the patient’s condition evolves.