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Palliative Care Access to Core Medicines (PCAM) Project – Metropolitan Melbourne

PCAM resources
Blue Eastern Melbourne PHN logo
logo on PHN north western melbourne
blue South Eastern Melbourne PHN logo

The Palliative Care Access to Core Medicines (PCAM) project assists people who wish to die at home by providing timely access to essential medicines, thereby minimizing suffering associated with emergent end-of-life symptoms. This project was initially funded by the North Western Melbourne Primary Health Network (NWMPHN) with the aim of supporting palliative care in the community.

 

The Pharmaceutical Society of Australia (PSA) was first commissioned by NWMPHN to coordinate this project in 2021. The project has now expanded to include the South Eastern Melbourne Primary Health Network (SEMPHN) and the Eastern Melbourne Primary Health Network (EMPHN). In this phase, PSA will engage with pharmacies in all three PHN regions (EMPHN, NWMPHN and SEMPHN).

PCAM – Letter of Intent

NWMPHN, SEMPHN, EMPHN and PSA invite all community pharmacists within their regions to read the Letter of Intent and agree to stock medicines on the Core Medicines List.

 

If you choose to complete the Letter of Intent, your pharmacy name and address will be published on a list of community pharmacies that have made this commitment.

 

The list will appear on public-facing directories and health care provider portals such as the PHNs’ websites, this PSA online hub and HealthPathways Melbourne to enable the public, general practitioners and other healthcare professionals to locate community pharmacies who support palliative care.

Participating community pharmacies

FAQs

The Palliative Care Access to Core Medicines (PCAM) Project aims to support palliative care in the community with a primary focus on end-of-life care, through enhanced planning and access to essential medicines in aid of people who wish to die at home.

 

The aims of the project are to:

  1. Increase awareness and use of the CML with prescribers, community palliative care providers and community pharmacists.
  2. Increase the number of community pharmacies stocking all medicines in the CML
  3. Increase awareness of anticipatory prescribing
  4. Increase collaboration between general practitioners and community pharmacists for end-of-life care.
  5. Improve timely access to palliative care medicines for patients.

The CML was developed as part of the PCAM Project initially funded by NWMPHN in 2021. The CML addresses the main symptoms commonly seen during terminal phase (pain, delirium, nausea, dyspnoea, and noisy breathing), and considers affordability and accessibility.  It also considera the need for parenteral administration and availability through the Pharmaceutical Benefits Scheme. For this expansion of the project, SEMPHN and EMPHN are using the same list developed in the NWMPHN project.

 

The use of a CML can minimise barriers that prevent access for patients, and facilitate timely anticipation, prescription, supply and use of medicines for end-of-life symptom management. Ranging the CML in pharmacies across the PHNs will reduce the instances where a carer needs to visit multiple pharmacies before finding the medicines prescribed for emerging and urgent symptoms, especially outside of standard business hours.

The list includes the medicines endorsed by the Australian and New Zealand Society for Palliative Medicines for use in community-based palliative patients and considered the core palliative care medicine lists published in other states.  This list was established for NWMPHN’s region through consultation with local palliative care providers. For this expansion of the project, SEMPHN and EMPHN are using the same list developed in the NWMPHN project to maintain consistency within the metropolitan Melbourne region.

 

Table of medicines for PCAM project

 

Community pharmacies are encouraged to stock these first-line medicines as this is the recommended list that will be communicated in the region. Additional medicines to the list may be stocked dependent upon local prescribing preferences and/or stock availability.

 

Note (8 November 2023): 

We are aware of some supply issues with metoclopramide injection, including the discontinuation of the PBS-listed Maxolon injection. Alternative brands of metoclopramide have not yet been listed on the PBS. However, as their cost is not prohibitively expensive, our recommendation to prescribers is to continue to prescribe metoclopramide as first line antiemetic medicine. Haloperidol injection (PBS-listed) is also an appropriate alternative therapy for nausea and vomiting in palliative care while these supply issues continue, however it is more sedating.   

 

This list does not restrict which medicines can be prescribed for individual palliative patients as some medicines may not be appropriate in certain circumstances (i.e. metoclopramide/haloperidol is best avoided in Parkinson’s Disease).  However, it is one approach which will allow community pharmacies to anticipate medicines most likely to be prescribed allowing prescribers to anticipate medicines most likely to be available for rapid supply in community pharmacies and residential aged care facilities within the metropolitan Melbourne region. We recommend discussing any questions with your local specialist Community Palliative Care service provider.

Enough stock should be held in a community pharmacy to provide an initial urgent supply to a patient/carer, until more stock arrives in the next scheduled medicine order to fulfil the prescription quantity. For most pharmacies, this would mean keeping a minimum of one box of each medicine.

The PCAM project will:

  • Contact community pharmacies in SEMPHN, EMPHN, and NWMPHN’s regions about the CML, and encourage pharmacists to range the CML
  • Develop and maintain an online hub of palliative care resources relevant to pharmacists and prescribers.
  • Develop and maintain an online mapping resource that shows the locations of pharmacies that have agreed to range the Core Medicines List within SEMPHN, EMPHN, and NWMPHN’s regions.

Please refer to the link to the Google Map embedded in this online hub.

Please fill out the form and email to Sam.Flood@psa.org.au

 

Alternatively, you can complete the Letter of Intent online.

 

For more information about the PCAM project, or for questions relating to the project activities, please email Sam.Flood@psa.org.au

Webinars

Links to recorded webinars that were delivered in the earlier phase of this project are listed below.

 

• Medicines in the last days of life; anticipatory medicines and medication management for end-of-life

Link to recording: HERE

 

• Medicines in the last days of life: anticipatory medicines and medication management for end-of-life care (19th August 2021) – Hosted by EMPHN

Link to recording: HERE

 

• Supporting palliative care patients in residential aged care: for GPs and pharmacists (19th October 2021)

Link to recording HERE

PSA Resources

External Resources

  • Postgraduate unit (PGC5118 Palliative care)– The faculty of Pharmacy and Pharmaceutical Sciences at Monash University offers a postgraduate unit that focusses on the pharmacological and non-pharmacological management of symptoms in palliative and end of life care.