Palliative Care Access to Core Medicines

Status
Active

$178,500 (ex. GST)

Funding Amount

January 2021 to January 2022

Duration

Whole region

Locations

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.

 Palliative Care Access to Core Medicines – FAQs

Outcomes

The anticipated outcomes of this project are:

  1. a CML based on:
    • the best evidence for treating terminal phase symptoms
    • established CMLs in other settings
    • preferences of local palliative care providers.
  2. increased awareness and use of the CML by prescribers
  3. increased number of community pharmacies stocking all medicines in the CML
  4. increased awareness of anticipatory prescribing
  5. increased collaboration between general practitioners and community pharmacists with regards to end-of-life care
  6. improved timely access to palliative care medicines for patients.

Which pharmacies stock the CML?

The PSA is currently contacting pharmacies in our region to encourage them to stock the medicines in the CML. The list of pharmacies who have agreed to stock the CML will be on the PSA website and HealthPathways Melbourne, once pharmacies have confirmed their participation.

Services involved