Palliative care access to core medicines (establishment phase)
January 2021 to March 2022
$201,833.30 (ex. GST)
all
Overview
North Western Melbourne Primary Health Network (NWMPHN) has commissioned the Pharmaceutical Society of Australia (PSA) to deliver the Palliative Care Access to Core Medicines (PCAM) project. This project aims to support palliative care in the community by increasing access to essential medicines for people who wish to die at home or in an aged care setting.
The project has established the Core Medicines List (CML) below.
Core Medicines List for community palliative care patients in the NWMPHN region
| Medicine Category | First Line Medicines | Minimum Quantity to stock | Indication/(s) for use in terminal phase patients |
| Anxiolytic
|
Clonazepam 2.5mg/mL (0.1mg/drop) Oral Liquid
Midazolam 5mg/mL Injection (If an injection is required or preferred) |
10mL bottle
5 or 10 ampoules
|
Agitation associated with delirium
Anxiety associated with dyspnoea |
| Antipsychotic | Haloperidol 5mg/mL Injection | 10 ampoules
|
Agitation
Nausea, vomiting
|
| Anticholinergic | Hyoscine butylbromide 20mg/mL Injection | 5 ampoules
|
Respiratory tract secretions
Noisy breathing |
| Antiemetic | Metoclopramide 10mg/2mL Injection | 10 ampoules | Nausea, vomiting |
| Analgesic
(High potency opioid) |
Morphine (sulfate or hydrochloride) 10mg/mL and/or 30mg/mL Injection | 5 ampoules | Dyspnoea
Pain |
This CML was informed by evidence and through consultation with local palliative care providers.
It addresses the main symptoms commonly seen during the terminal phase of palliative care (pain, delirium, nausea, hoarseness and noisy breathing). It also takes into account affordability and accessibility, by considering the need for parental administration and availability through the Pharmaceutical Benefits Scheme.
The CML can minimise access barriers for patients. It can facilitate timely prescription, supply and use of medicines for end-of-life symptom management by ensuring alignment across the service system.
Outcomes
Achieved outcomes
- Development with prescribers and pharmacists of an agreed list of stocked palliative care medications.
- Improvement in timely access to palliative care medications.
- Increased collaboration between general practitioners and community pharmacists with regards to end-of-life care.
Pharmacies in NWMPHN’s region that stock the CML
You can find a map of pharmacies who have agreed to stock the CML here.
Lessons learnt
While this activity helped improve timely access to palliative care medicines, ongoing promotion via palliative are professional development, quality improvement activities and collaboration with palliative care providers will be required to sustain access to these essential medicines.
This project has since been extended.
Services involved
