The role of pharmacists in home-based palliative care

While the majority of Australian palliative care patients want to be cared for and die at home, less than 10 per cent achieve that wish. But pharmacists are able to provide a supportive role to both home-based palliative care patients and their carers.

A new national project led by the Brisbane South Palliative Care Collaborative and funded by the Australian Government, caring@home provides resources to aid carers and their healthcare teams to support those who wish to be palliated at home.

Project Director, Prof. Liz Reymond said that apart from unwanted admissions and associated unnecessary healthcare costs, failure to achieve timely and effective control of symptoms has enormous consequences.

‘When symptoms are not adequately managed, it can result in tremendous distress to patients, carers and community service providers alike,’ she said.

The goal of caring@home is to support terminally-ill patients who want to be cared for and to die at home. caring@home achieves this by providing free resources to healthcare professionals, community services and carers, so carers can be trained to manage breakthrough symptoms safely in the person they are caring for.

Carers have reported feeling disempowered when unable to provide adequate symptom management to patients. Southern Adelaide Palliative Services Lead and Palliative Care Pharmacist Paul Tait said community pharmacists could support carers by stocking medicines required by the patient and providing advice, within their scope of practice, to carers giving subcutaneous medicines.

‘As people approach the terminal phase, they lose the ability to swallow – dysphagia – which has implications on how symptoms can be managed in this critical phase,’ Mr Tait said.

Dysphagia means that subcutaneous medicines are often needed for symptom control, and pharmacists can support patients and carers by stocking a patient’s prescribed medicines.

‘Community pharmacists can struggle to anticipate which medicines to stock,’ Mr Tait said, ‘meaning that prescribers and carers are encouraged to liaise with pharmacists ahead of time and for pharmacists to consider anticipatory prescribing.’

To find more about the supportive role pharmacists can play in palliative care, access the following resources:

• Guidelines for the handling of palliative care medicines in community services: https://www.caringathomeproject.com.au/Portals/13/Documents/NPS-Palliative-Care-Guidelines-v16-jg-171018-ACC.PDF
• Project information sheet for community pharmacists: https://www.caringathomeproject.com.au/Portals/13/Documents/INFO-sheet-CPs-PRINT.PDF
• caring@home website page for community pharmacists: https://www.caringathomeproject.com.au/tabid/5156/Default.aspx
• More resources, including a consensus-based list of medicines suitable for use in the community for managing terminal symptoms and example policy and procedures documents are available at: https://www.caringathomeproject.com.au/