Medicines and Palliative Care Information Resources

There are several challenges that present in the people with palliative care needs.

The following resources may be useful in understanding and responding to these.

General palliative care resources:

• CareSearch
  Provides access to evidence to inform best practice in palliative care across the life course. Includes evidence summaries on clinical topics, and information and resources for health professionals and the broader community.
  • Palliative Care Community Pharmacy Updates
    Monthly update for community pharmacists involved in the delivery of services to people with palliative care and their families.
• ELDAC
  Provides information, guidance, and resources to health professionals and aged care workers to support palliative care and advance care planning to improve the care of older Australians.
• palliAGED
  An online evidence-based guidance and knowledge resource about palliative care in aged care for use by health professionals and the aged care workforce. Replaces the Guidelines for a Palliative Approach in Residential Aged Care (APRAC) and the Guidelines for a Palliative Approach for Aged Care in the Community Setting (COMPAC).
• Scottish Palliative Care Guidelines
  Reflect a consensus about good practice in the management of adults with life-limiting illness.
• Tasmanian Palliative Care Formulary
  Australian resource for healthcare professionals who care for adults requiring palliative care.
• Therapeutic Guidelines: Palliative Care (subscription required)
  Provides advice from expert clinicians on a range of practical palliative care issues, including symptom management, communication guidance and support for deprescribing.

General dosing guides:

• Australian Medicines Handbook
  Evidence-based independent medicines reference in an Australian context.
• MIMS Online has information on medications including guidance on those suitable for crushing where people have difficulty swallowing or have an enteral feeding tube in place (subscription required).
• Scottish Palliative Care Guidelines
  Reflect a consensus about good practice in the management of adults with life-limiting illness.
• Tasmanian Palliative Care Formulary
  Australian resource for healthcare professionals who care for adults requiring palliative care.

Last days of life:

• Anticipatory prescribing
  • Anticipatory medicines, Statewide guidance for Victoria, Safer Care Victoria.
• Opioid Conversion calculators:
  • eviQ opioid calculator
  • Australian and New Zealand College of Anaesthetists (ANZCA): Opioid Calculator app
  • Guidance: Opioid conversion ratios (572kb pdf), Safer Care Victoria 2021.
• palliAGEDgp app (available as an app or online)
  Smartphone app designed to support care of older Australians with palliative needs living at home or in residential care. It includes terminal prescribing advice. Useful for prescribers and pharmacists.
• palliAGED symptoms and medicines pages.
• palliMEDS.
  Developed by NPS MedicineWise for caring@home, familiarises primary care prescribers with eight palliative care medicines that have been endorsed by the Australian & New Zealand Society of Palliative Medicine (ANZSPM) for management of terminal symptoms. Also includes an opioid calculator tool.
• Syringe driver compatibility
  • Syringe driver compatibility Guidance Document (689kb pdf), Safer Care Victoria.

Medicine management Tools:

• Assessing Suitability for a Dose Administration Aid (92kb pdf)
• Informed Consent Fact Sheet from the Australian Commission on Quality and Safety in Health Care 
• Medicine handling guidelines for palliative care, from the Caring at home project
• NPS MedicineWise app for patients to self-manage medicines and health information
• Online fillable Medicines list (88kb pdf) from palliAGED
• Paper medicines lists from NPS
• palliPHARM Factsheets including:
  • Disposing of your palliative care medicines safely
  • Palliative Care Medicines
  • Storing your palliative care medicines safely.

Guidance in palliative care:

• The Royal Australian College of General Practitioners (RACGP). RACGP aged care clinical guide (Silver Book) [Internet]. East Melbourne, Vic: RACGP; 2019.
• British Geriatrics Society. End of Life Care in Frailty [Internet]. 2020 [cited 2021 Mar 25].

Articles:

• Curtin D, Gallagher P, O'Mahony D. Deprescribing in older people approaching end-of-life: development and validation of STOPPFrail version 2. Age Ageing. 2021 Feb 26;50(2):465-471. doi: 10.1093/ageing/afaa159.
• Gallagher P, Ryan C, Byrne S, Kennedy J, O'Mahony D. STOPP (Screening Tool of Older Person's Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment). Consensus validation. Int J Clin Pharmacol Ther. 2008 Feb;46(2):72-83. doi: 10.5414/cpp46072.
• Lavan AH, Gallagher P, Parsons C, O'Mahony D. STOPPFrail (Screening Tool of Older Persons Prescriptions in Frail adults with limited life expectancy): consensus validation. Age Ageing. 2017 Jul 1;46(4):600-607. doi: 10.1093/ageing/afx005.
• Liacos M, Page AT, Etherton-Beer C. Deprescribing in older people. Aust Prescr 2020;43:114-20. doi: 10.18773/austprescr.2020.033.
• Pruskowski J, Handler SM. The DE-PHARM Project: A Pharmacist-Driven Deprescribing Initiative in a Nursing Facility. Consult Pharm. 2017 Aug 1;32(8):468-478. doi: 10.4140/TCP.n.2017.468.
• Scott IA, Hilmer SN, Reeve E, Potter K, Le Couteur D, Rigby D, et al. Reducing inappropriate polypharmacy: the process of deprescribing. JAMA Intern Med. 2015 May;175(5):827-34. doi: 10.1001/jamainternmed.2015.0324.
• Tait P, Chakraborty A, Tieman J. The Roles and Responsibilities of Community Pharmacists Supporting Older People with Palliative Care Needs: A Rapid Review of the Literature. Pharmacy (Basel). 2020 Aug 12;8(3):143. doi: 10.3390/pharmacy8030143.

Education:

• End of Life Essentials provides free online education based on the Australian Commission on Safety and Quality in Health Care’s National Consensus Statement: Essential elements for safe and high-quality end-of-life care.
• Cancer Council WA has a six video series for all health professionals on Pharmacological Interventions for Palliative Care Symptoms
• The Pharmaceutical Society of Australia provides Palliative Care Essential CPE for self-paced learning. They also host a series of podcasts and additional Palliative Care Essential online courses for pharmacists covering:
  • Polypharmacy and Deprescribing in Palliative Care
  • Medicines in the Last Days of Life
  • Final medicines in palliative care.

Videos:

These videos were produced for the palliAGED or Decision Assist projects.

• Professor Liz Reymond - Providing care to older Australians at the end of life.
• Dr Greg Parker - Pain assessment, management and initiating opioids.
• Dr Will Cairns - Introduction to management of delirium in palliative care.
• Dr Lawrie Palmer - Introduction to management of nausea and vomiting in palliative care.
• Professor David Currow - Introduction to management of dyspnoea in palliative care.
• Neil Petrie - The roles pharmacists play in the Aged Care setting at the end of life.
• Deprescribing videos.

Page created 17 March 2021