Palliative Care Access to Core Medicines
$178,500 (ex. GST)
January 2021 to January 2022
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|
|Clonazepam 2.5mg/mL (0.1mg/drop) Oral Liquid
Midazolam 5mg/mL Injection
(If an injection is required or preferred)
5 or 10 ampoules
|Agitation associated with delirium
Anxiety associated with dyspnoea
|Antipsychotic||Haloperidol 5mg/mL Injection||10 ampoules
|Anticholinergic||Hyoscine butylbromide 20mg/mL Injection||5 ampoules
|Respiratory tract secretions
|Antiemetic||Metoclopramide 10mg/2mL Injection||10 ampoules||Nausea, vomiting|
(High potency opioid)
|Morphine (sulfate or hydrochloride) 10mg/mL and/or 30mg/mL Injection||5 ampoules||Dyspnoea
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.
The anticipated outcomes of this project are:
- a CML based on:
- the best evidence for treating terminal phase symptoms
- established CMLs in other settings
- preferences of local palliative care providers.
- increased awareness and use of the CML by prescribers
- increased number of community pharmacies stocking all medicines in the CML
- increased awareness of anticipatory prescribing
- increased collaboration between general practitioners and community pharmacists with regards to end-of-life care
- 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.