North Western Melbourne Primary Health Network Palliative Care Access to Core Medicines (PCAM) Project

The CML has been developed as part of the PCAM Project which is funded by NWMPHN. The Core Medicine List (CML) addresses the main symptoms commonly seen during terminal phase (pain, delirium, nausea, dyspnoea, and noisy breathing), and also takes in to account affordability and accessibility, by considering the need for parenteral administration and availability through the Pharmaceutical Benefits Scheme.

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 PHN 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 in NWMPHN’s region.

Community pharmacies are encouraged to stock these first-line medicines or may substitute these medicines dependent upon local prescribing preferences and/or stock availability.

This list does not restrict which medicines can be prescribed for individual palliative patients, but is one approach which will allow community pharmacies to anticipate medicines most likely to be prescribed, and allow prescribers to anticipate medicines most likely to be available for rapid supply in community pharmacies and RACFs within the NWMPHN region.

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:

• Develop and deliver education webinars targeted towards pharmacists, general practitioners (GPs) and Residential Aged Care Facility staff
• Contact general practices in NWMPHN’s region to create awareness about anticipatory prescribing and the role of the CML
• Contact community pharmacies in NWMPHN’s region 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 an online mapping resource that shows the locations of pharmacies that have agreed to range the Core Medicines List within NWMPHN’s region

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

Please fill out the form and email to Adeline.Tan@psa.org.au

Alternatively, you can complete the Letter of Intent online by clicking on the weblink below/copying the weblink into your web browser https://www.surveymonkey.com/r/PRM77TC

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

A series of collaborative health practitioner workshops focused on medicines management for end-of-life care which as funded by the South Australian Government through the Palliative Care 2020 Grants Program.

SA Palliative Care Medication Masterclass series

• Dos and don’ts on palliative care – May 2021
• What role do pharmacists play in palliative care? – June 2020
• Systemic Corticosteroids for Dyspnoea – April 2019
• Deprescribing in the Elderly – September 2018
• Pharmacists supporting patients with palliative care needs – November 2017
• Pancreatic cancer: a deadly disease in the elderly – September 2017

Therapeutic Guidelines: Palliative Care (Requires Subscription)

• Palliative Care Victoria
• Supporting a person who needs palliative care – A guide for families and friends

• Palliative Care Australia
• Palliative Care 2030 projection document
• Palliative Care Services Directory (Searchable database)
• Dementia and Palliative Care

• Evidence-based hub for palliative care
• Palliative care Information hub for Aboriginal and Torres Strait Islander people
• Community Pharmacy Resource Page

Palliative care evidence and practice resources for Aged Care

Palliative Care Discussions training

• Core Palliative Medicines
• End Stage Heart Failure
• End of Life Care for Patients with Cancer
• Palliative care in general practice: GP integration in caring for patients with advanced cancer
• End-of-life care: Proactive clinical management of older Australians in the community
• RACGP Aged Care Clinical Guide (Silver Book)

National Palliative Care Strategy 2018

• Advance Care Planning Australia
• Advance Care Planning Australia Learning

• Statistical Information: Palliative Care Services in Australia
• Palliative care services in Australia

National Consensus Statement: Essential elements for safe and high-quality end-of-life care

Demographic data for Australia

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.

Caring@home Project resources – to support carers and families Australia wide to manage breakthrough symptoms safely

Clinical Practice Guidelines for Quality Palliative Care, 4th edition

• The prevalence of multimorbidity, and its impact on polypharmacy
• Palliative Care in Australia
• Exploring the community pharmacist’s role in palliative care: Focusing on the person not just the prescription
• Home-based support for palliative care families: challenges and recommendations
• Piloting the role of a pharmacist in a community palliative care multidisciplinary team: an Australian experience
• Community Pharmacists’ Attitudes Toward Palliative Care: An Australian Nationwide Survey
• Care of the Dying: Setting Standards for Symptom Control in the Last 48 Hours of Life
• Using National Health Policies to Improve Access to Palliative Care Medications in the Community
• Clinical networks influencing policy and practice: the establishment of advanced practice pharmacist roles for specialist palliative care services in South Australia
• Factors affecting access to subcutaneous medicines for people dying in the community
• Forging an advanced practice role for pharmacists in palliative care
• Improving community access to terminal phase medicines in Australia: identification of the key considerations for the implementation of a ‘core medicines list’
• Medication use in aged care residents in the last year of life: A scoping review
• The Roles and Responsibilities of Community Pharmacists Supporting Older People with Palliative Care Needs: A Rapid Review of the Literature