None listed
Conditions
Brief summary
A recent survey of community pharmacies across South Australia (unpublished) concluded that it is difficult for community pharmacies to anticipate which medicines to stock for the treatment of symptoms commonly seen in the terminal phase of a palliative illness. This information ties in with other published qualitative studies As a result, a South Australian Palliative Care Formulary Working Party formed and subsequently developed an End of Life Essential Medicines List. This list of medicines was determined following a review of the 6 most frequently encountered symptoms noted in the terminal phase of a palliative illness - nociceptive pain, agitation, nausea/vomiting, dyspnoea, delirium and noisy breathing. The final list of medications was informed by the Working Party’s experience, the Palliative Care Therapeutic Guidelines and other locally used guidelines. The Working Party settled on these medications based on their efficacy, their usefulness in managing more than one symptom and availability on the Schedule of Pharmaceutical Benefits (PBS): - Morphine 10mg/mL Injection - Haloperidol 5mg/mL Injection - Metoclopramide 10mg/2mL Injection - Hyoscine butylbromide 20mg/mL Injection -Clonazepam 1mg Injection A hub pharmacy will be selected in the Victor Harbor Statistical Local Area (SLA): postcode: 5211 The location of the hub pharmacy will be shared with all other community pharmacies within the SLA to encourage quick access to medicines. The location of the hub pharmacy will not be shared with GPs, Nursing homes or patients and their carers. This is a quality improvement initiative. The aim of this audit is to evaluate the impact of this quality improvement strategy on: -Supporting local community clinicians to provide palliative care for non-complex patients through the standardisation of prescribing; -The viability for community pharmacies to stock medicines from an end of life essential medicines list; and -The impact of having a pharmacy hub in a SLA to support prompt and efficient supply of palliative medicines.
Interventions
To provide educational support, in the form of academic detailing, to general practitioners to guide prescribing for palliative symptoms to 1 of 5 medicines: metoclopramide 10mg/2mL injection, morphine 10mg/mL injection, hyoscine butylbromide 20mg/mL injection, haloperidol 5mg/mL injection or clonazepam 1mg injection
The academic detailing will involve individual appointments with each general practitioner in the study area, to deliver consistent education messages. These will occur within a 30
To provide educational support, in the form of academic detailing, to general practitioners to guide prescribing for palliative symptoms to 1 of 5 medicines: metoclopramide 10mg/2mL injection, morphine 10mg/mL injection, hyoscine butylbromide 20mg/mL injection, haloperidol 5mg/mL injection or clonazepam 1mg injection The academic detailing will involve individual appointments with each general practitioner in the study area, to deliver consistent education messages. These will occur within a 30 minute time period and as a single visit for each practitioner.
Sponsors
Kate Swetenham
Eligibility
Sex/Gender
All
Age
0 to No maximum
Healthy volunteers
No
Inclusion criteria
Patients will not be enrolled into this study general practitioners , community nurses and community pharmacists will be voluntarily enrolled and the inclusion criteria is that they are based in the City of Victor Harbor (council zone).
Exclusion criteria
Patients will not be enrolled into this study
Outcome results
None listed