What role do pharmacists play in end-of-life care?

As medicines experts, pharmacists have a key role in supporting people with palliative care needs, as well as their carers and the broader multidisciplinary healthcare team.

Pharmacists are among the most trusted health professionals and are highly accessible in the community. This can be especially valuable in rural and remote parts of Australia, where access to palliative care support may be more limited than in metropolitan areas.

Pharmacists play a critical role in ensuring timely access to the medicines needed for management of a range of symptoms people may experience towards end of life. Further, for people with palliative care needs and their carers, the support pharmacists provide includes counselling on medicines use, assistance with prescription management, advice around cost minimisation, and practical supports like arranging for home delivery of medicines and consideration of a dose administration aid to help with adherence.

Pharmacists also support prescribers and the broader healthcare team by providing information around medicine dosages, consideration of potential side effects and drug interactions, optimising use of the PBS Palliative Care listings, recommending different formulations (for instance, if swallowing becomes a problem for the person) and suggesting alternative treatment options in the event of medicine shortages.

Should a family carer inform their local pharmacist that they’re caring for someone at the end of life?

There is an enormous benefit in a family carer letting their local pharmacist know that they’re caring for someone with palliative care needs.

Early notification, ideally around the time of diagnosis of a life limiting illness, prompts the pharmacist to regularly ‘check in’ with the person and their carer, being especially alert for signs that the person’s condition and healthcare needs may be changing.

This enables the pharmacist to anticipate the need for a range of services and supports and to offer these in advance. As a knowledge broker, the pharmacist can also advocate on the person's behalf to enhance care coordination with other health professionals involved in their care. For example, by collaborating with prescribers to anticipate a person’s medication needs, the pharmacist can ensure they have prescribed medicines available for access when needed.

This can have profound benefits to a person’s quality of life, can decrease stress and confusion, and potentially reduce unwanted transfers to hospital for people who ultimately wish to remain at home for care in the terminal phase of their life.

Pharmacists are also very well placed to support carers with their own health needs, recognising that the burden of caring for someone who is nearing end of life often means that carers deprioritise their own health and wellbeing.

How is PSA up-skilling pharmacists for end-of-life care?

The Pharmaceutical Society of Australia (PSA), as the peak body representing Australia’s 37,000 pharmacists working in all practice settings, is committed to lifting the baseline palliative care knowledge of the profession to help meet the needs of the growing number of people who are approaching the end of their lives, and their carers.

With funding from the Australian Government Department of Health under the National Palliative Care Projects grant program, PSA is currently developing a palliative care foundation training program which will be available to all Australian pharmacists free of charge from May 2025. This training program will comprise 8 modules of online, interactive, self-directed learning, and aims to build the skill, knowledge and compassion of pharmacists to support people with palliative care needs, their carers and other health professionals involved in palliative care.

How are CarerHelp and PSA working together to better support family carers?

PSA and CarerHelp are working closely together in a number of ways to support family carers.

In PSA’s upcoming palliative care foundation training program for pharmacists, an entire module has been dedicated to the role of pharmacists in recognising and responding to the needs of carers who are looking after a person with a life limiting illness.

CarerHelp and PSA have also collaborated on a consumer/carer resource to raise awareness of the wide range of services and support from community pharmacies and pharmacists available to those caring for someone approaching the end of their life. You can view the new resource here.

PSA has shared this resource with pharmacists nationally, and actively encourages pharmacists to both refer to the CarerHelp website and to direct carers there to find valuable guidance and practical support.

Author:

Megan Tremlett, Senior Pharmacist, Pharmaceutical Society of Australia (PSA)