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Pharmacy supply of core medicines for symptom management at end of life

Community pharmacies from Glenelg to Victor Harbor now have quick access to a standard list of core medicines useful for symptom management in the last days of life.

Last year, over a quarter of patients registered with the Southern Adelaide Palliative Services (SAPS) remained at home to die - this proportion is probably higher for those being cared for solely by their GP. Good symptom management at home is essential for people to avoid hospitalisation.

Therefore, availability of injectable and oral liquid medicines from the patient’s usual pharmacy is important to be able to respond to end-of-life symptoms, in a timely manner. This impacts not only the patient but also their carers.

Research has shown that community pharmacists are unable to anticipate the range of medicines to stock and do not stock all medicines that may be requested infrequently at end of life.

An innovative approach, developed by SAPS, ensures all community pharmacies from Glenelg to Victor Harbor have quick access to a standard list of core medicines useful for symptom management in the last days of life:

  • Clonazepam 1mg Injection
  • Haloperidol 5mg/mL Injection
  • Hyoscine butylbromide 20mg/mL Injection
  • Metoclopramide 10mg/2mL Injection
  • Morphine 10mg/mL Injection

The availability of these medicines forms a safety-net for all prescribers: ensuring that palliative patients have access to timely symptom control, through their usual community pharmacy. It is expected that some GPs, through personal preferences, will prescribe different medicines and formulations. With this list in mind, GPs are encouraged to liaise with the patient’s usual pharmacy prior to prescribing medicines that are beyond this list, to ensure their preferred alternatives are available. 

Doses should always be individualised and based on reputable texts, such as the Palliative Care Therapeutic Guidelines. For more information about this patient-centred approach to palliative care, call Paul Tait by email or on 8275 1732.

Information provided by Souther Adelaide Palliative Services, 18 July 2014