The Palliative Care Access to Core Medicines (PCAM) project aims to support palliative care in the community and assists people who wish to die at home through timely access to essential medicines. This minimises suffering associated with emergent end-of-life symptoms.
SEMPHN, Eastern Melbourne PHN (EMPHN) and North Western Melbourne PHN (NWMPHN) are proud to have partnered with The Pharmaceutical Society of Australia (PSA), the peak national organisation for pharmacists working in all sectors to deliver this project.
Core Medicine List Information
The Core Medicines list (CML) 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 first for the NWMPHN region through consultation with GPs, Pharmacists and local palliative care providers. Utilisation of the existing core medicines list in SEMPHN and EMPHN regions ensures consistency across metropolitan Melbourne.
| 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) | 10 mL 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 hydrochlordie) 10mg/mL and/or 30mg/mL Injection | 5 ampoules | Dyspnoea Pain |
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.
Update from PSA 17 January 2024
We acknowledge supply challenges with metoclopramide injection, including the discontinuation of PBS-listed Maxolon. Another non-PBS brand is available, and a new PBS-listed brand is expected in January 2024, though stock availability is pending. Given the reasonable cost of the non-PBS option, we recommend continued prescription of metoclopramide as the first-line antiemetic. Haloperidol injection (PBS-listed) is a suitable alternative for nausea and vomiting in palliative care, despite its higher sedation potential, during these supply challenges.
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.
Map of participating community pharmacies
The map below shows the location of participating local community pharmacies that have agreed to stock the CML to facilitate timely access to palliative care medicines. Although listed pharmacies have agreed to stock the above medicines, we suggest calling ahead of time to ensure stock availability. Please note, the below list of participating pharmacies is not exhaustive, and new pharmacies will be onboarded.
Webinar
Medicines in the last days of life: anticipatory medicines and medication management for end-of-life care
This recorded webinar will equip general practitioners, community pharmacists, and other health professionals with knowledge about anticipatory medicines and medication management for end-of-life care.
Why is this important?
The recorded webinar provides information and resources regarding the practical and legal aspects of prescribing and supplying medicines for end-of-life care.
The webinar outlines the establishment of a local evidence-based core medicines list to improve timely access to palliative care medicines for patients. The presenters also consider non-pharmacological options and referral pathways to support end-of-life care.
Learning Objectives
Upon completion of this webinar, General Practitioners should be able to:
- Explain the benefits of anticipatory medicines in end-of-life care
- Discuss the legal and practical aspects of anticipatory prescribing and supplying anticipatory medicines
- Recall the localised core medicines list for end-of-life care
- Locate referral pathways to support end-of-life care
- Identify non-pharmacological treatment options for end-of-life care
RACGP CPD hours are available for General Practitioners.
How to access the webinar?
The webinar is accessible through the Eastern Melbourne PHN platform.
Instructions:
- Click here to be directed to the webinar
- Enter the webinar password: MLDL@EMPHN1
- Register yourself, upon completion you will be able to watch the webinar.
- Upon completion of watching the PCAM Anticipatory medications webinar in its entirety, you will receive an email with your certificate attendance and your hours will be lodged by the end of the month.
Are you a pharmacist interested in supporting palliative care?
SEMPHN, EMPHN, NWMPHN 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 map/list of community pharmacies that have made this commitment.
The map/list will appear on public-facing directories and health care provider portals such as the PHN’s websites, the PSA online hub and HealthPathways Melbourne to enable the public, general practitioners and other healthcare professionals to locate community pharmacies who support palliative care.
You can also contact SEMPHN at:
palliativecare@semphn.org.au
Alternatively, if you would like to download and complete the letter of intent, please use this PDF version, which when completed, can be emailed back to palliativecare@semphn.org.au.
Visit the Pharmaceutical Society of Australia to learn more.
PCAM Brochure
Download the
PCAM brochure for distribution with your healthcare team and patients.
The National Core Community Palliative Care Medicines List
This list was developed to create a core medicines list applicable across all Australian states and territories, in a similar fashion to the PCAM Project but on a national scale. The PCAM Project CML contains the same medicines as the National Core Community Palliative Care Medicines List, with the addition of Metoclopramide 10mg/2mL Injection. This integration not only aligns effectively with the national list but also ensures sustainability moving forward.
Additional resources
- Safer Care Vic Anticipatory Medications Guidelines
- Palliative Care Advice Service, Phone: 1800 360 000, 7 am – 10 pm, seven days per week
- PHN Palliative Care page
South Eastern Melbourne PHN
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