Home' Australian Pharmacist : Australian Pharmacist May 2012 Contents Australian Pharmacist May 2012 I ©Pharmaceutical Society of Australia Ltd. 365
Communication -- or the lack of it --
between pharmacists, doctors and other
members of the palliative care team is
perceived to be one of the major problems
restricting pharmacists from assuming a
more active role as part of end-of-life care
for dying patients.
Palliative care is very di erent to end-of-life
care which may come into e ect shortly
before end-of-life. Palliative care often is
incorporated months before death and
makes sure the patient is comfortable and
physically and emotionally prepared for
their nal journey.
Yvonne Luxford, Chief Executive O cer of
Palliative Care Australia, the organisation
which describes itself as the peak national
organisation representing the interests
and aspirations of all who share the ideal
of quality care at the end of life for all,
says while lack of communication is a
problem, its cause can't be slated home to
any one particular group.
'The lack of communication is a systemic
problem. In the palliative care standards,
pharmacists are considered part of the
multi-disciplinary team but the extent to
which they are actually part of the team is
something we need to address. Including
them more is certainly a function of
communication to a large extent,' she said.
'I think the system of passing information
on to the pharmacist that a patient is
now actually receiving palliative care is
an area that we certainly need to look
at. Pharmacists need to be considered
part of the multi-disciplinary care model.
Information needs to be communicated
Peter Waterman is Director of Public
Affairs at PSA National Office in Canberra.
The palliative journey:
Keeping pharmacists in
By Peter Waterman
and we need to ensure that such
information is received and understood,'
Dr Luxford said.
'But on the ip side, pharmacists need
to be on the lookout for changes in the
medicines regimen of patients. They need
to be proactive.'
Professor Moyez Jiwa MD, of the Curtin
Health Innovation Research Institute
at Perth's Curtin University, says there
needs to be better communication so
pharmacists know the patient is palliative.
'As a GP I might write on the prescription
something along the lines of "If you want
more information about this please call
me" which is code for 'I need to talk to you
about this patient'. I can then talk to the
pharmacist and explain the implications
for the patient and for the pharmacist who
may need to stock a particular drug and so
on. This ensures the pharmacist is aware of
the change in status of the patient and is
better able to help them.'
Paul Tait, Palliative Care Pharmacist at
the Southern Adelaide Palliative Services
in South Australia, says one of the big
obstacles preventing pharmacists
providing more -- and better -- services
to patients in palliative care is certainly
the lack of communication among health
'One thing I have found is often the
pharmacist does not know the patient is
palliative, or has moved from curative to
palliative care,' Mr Tait said.
'The lines of communication between
patient and pharmacist, and the
pharmacist and other health professionals,
are not open. If the pharmacist knows the
patient is palliative this can change things
in terms of what they stock and so on.'
The Palliative Care
Paul Tait is one of three pharmacists
involved in an innovative program
which is part of the South Australian
Government's Palliative Care Service
Plan 2009--2016, under which the role
of pharmacists is not only recognised,
'The program is a new role for pharmacy
in general. The trend has been for
pharmacists to move from the generalist
model to specialising in a particular area
but this is another step beyond that,'
Mr Tait said.
'This is more about taking leadership
qualities into the project, to improve
the link with the community and the
'We are working on several di erent
areas. One is improving the access
to medicines for palliative patients,
while another is looking at education
and training programs for pharmacists
and other health professionals, the role
of HMRs in palliative care, and research
opportunities. So we are certainly
stepping away from the clinical role to
Mr Tait said until these roles began, there
had been a whole series of challenges in
getting medicines to palliative patients.
'Before this project, other health
professionals were working hard to get
around the system and improve things.
Now that we are on board we have been
welcomed by them as we are building on
the work they have already put into place,'
'Of course we anticipate there will be
challenges and roadblocks ahead but
there is great commitment by everyone
for the aims of the project to be realised.'
Mr Tait said the South Australian initiative
covered metropolitan and regional
areas so had to be developed with the
knowledge that not all pharmacies had
the same facilities or access to the same
services. In addition, some areas had
higher palliative needs than others so the
services may have to be targeted.
He said in South Australia 15% of patients
would die in home environments but this
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