Sustainable access to appropriate opioids for palliative care patients in Australia-preventing the need for crisis management

Abstract

The main goal of palliative care is to relieve suffering. Opioids are an essential part of the pharmacological options required to address suffering by helping to relieve the pain and chronic breathlessness that may be experienced by someone with a life-limiting illness. This paper considers the recent history and current issues of the ‘opioid crisis’ providing recommendations to which regulatory and peak bodies can work with the Australian government, ensuring consistent adherence to WHO guidelines maintaining access to evidence based opioid management for palliative care patients whilst actively avoiding unintended suffering restricted access can cause. The recommendations are as follows:

1. Review of the Palliative Care schedule of the Pharmaceutical Benefit Scheme

2. Support of prescribers with current evidence, clinical practice guidelines and regulatory frameworks

3. National opioid prescribing policies promoting linkages between palliative care and pain and addiction specialists.

4. National real time monitoring of all opioid prescriptions

5. Palliative care involvement in all opioids stewardship programs in acute services.

6. Reform Medical Benefits Schedule to improve access for primary and other speciality practitioners to provide palliative care services.

7. Compulsory palliative care education in undergraduate medical, nursing and allied health tertiary courses.

8. Adequate, consistent stock of evidence based opioids for palliative care in community pharmacies and residential aged care facilities.

These recommendations provide the regulatory guidance required to ensure persons with life limiting illness have continued access to safe and effective medication that can relieve suffering.

Keywords:

• palliative care
• opioids
• health reform
• sustainable policy
• symptom management

Disclosure statement

No potential conflict of interest was reported by the authors.