Pharmacy Professional Services
As people living with a life limiting illness deteriorate, there may be several professional services that can assist the person (or their caregiver) in remaining at home:
- Checking of Inhaler technique and providing education and support as needed
- Confirming that they are aware of the Pharmaceutical Benefits scheme (PBS) Safety net and letting them know how to access online information about this from Services Australia
- Enquiring if they are struggling to take medicines as prescribed (e.g. swallowing issues, adherence) and providing written and verbal medicines information advice
- Establishing staged supply arrangements to overcome risks in managing medicines at home where these have been identified
- Formally reviewing medicines, including a MedsCheck, a Home Medication Review, or Residential Medication Management Review
- Home delivery of medications
- Instructing/giving advice on smoking cessation
- Measuring of blood pressure and discussing results with the person including advice and education as needed
- Monitoring of blood glucose and discussing results with the person including advice and education as needed
- Providing a written list of the persons current medications
- Providing symptom management advice
- Providing or filling of dose administration aids; and
- Working collaboratively with care facilities to ensure suitable medicines are available and used safely.
Rationalisation of Medicines
People with palliative care needs have been identified as being at high risk of medication misadventure, adverse effects and consequently hospital admission. Long-term management of serious illness can result in the carryover of medications and increasing complexity of medication regimens. Pharmacists can help to address this through the rationalisation of medications to balance potential benefits and harms in line with the person’s goals of care.
Primary Health Tasmania offer a range of resources to support the rationalisation of medicines.
NPS Medicinewise has a useful article on Pharmacovigilance in relation to common palliative care symptoms and balancing the potential harms and benefit of medications.
The SPICT and SPICT4ALL Tools can be used to identify people whose health is deteriorating and would benefit from review of current medications and future planning.
Last Days of Life
The last days of life are associated with:
- Swallowing difficulties
- Development of new symptoms; and
- Exacerbation of existing symptoms.
Many medicines need to be administered subcutaneously. The PalliAGED symptoms and medicines pages provide a range of resources useful in the care of people in the last days of life.
Several medicines lists have been developed to guide community pharmacists on which medicines are useful to stock:
Use these lists to guide conversations with local prescribers.
Caregivers can be trained by health professionals to administer subcutaneous medicines. For more information refer to the caring@home project.
Return of Unwanted Medicines
Families may be unaware of what to do with medicines when they are no longer required.
Let them know about the Return of Unwanted Medicines (RUM) project.
Page created 17 March 2021