Ms Eimear O’Dwyer, Chief Pharmacist, Our Lady’s Hospice and Care Services, outlines the importance of providing an information service dedicated to patients’ palliative care needs

Based at Our Lady’s Hospice and Care Services (OLH&CS) in Dublin, the Palliative Medicines Information Service (Palliative Meds Info) is a free information and advice service on medicines in palliative care for all health professionals across the Republic of Ireland, regardless of their level of expertise.

Celebrating its 140th anniversary this year, Our Lady’s Hospice and Care Services, Ireland’s largest specialist palliative care provider, adopts a holistic approach to end-of-life care, meeting the wide range of needs of both patients and their families. 

The Palliative Meds Info service, now in its tenth year, is unique in that it is the only medicines information service in both Ireland and the UK that is dedicated to patients’ palliative care needs. The service was established in response to the volume and frequency of ad-hoc calls for information on medicines received by the OLH&CS pharmacy team and enabled them to better facilitate these requests. 

Using a broad range of standard and specialist literature resources, combined with practical experience, ensures comprehensive, well-researched, up-to-date responses to the clinical questions received. The service responds to telephone and email enquiries from healthcare professionals caring for patients with life-limiting illnesses and has developed a range of resources available on its website.

Managed by the Chief Pharmacist and a senior pharmacist, the service aims to encourage best practice with medicines in palliative care and to assist health professionals in the community, in hospitals and in hospices nationwide in providing the best care by giving them up-to-date, evidence-based information. 

Frequently, the necessary use of drugs beyond their licence presents a challenge, in that readily-available, relevant medicines information may not be easily available. As the Palliative Meds Information Service is provided by specialist pharmacists working day-to-day with patients as part of a multidisciplinary team at the hospice, it provides hospice-based expertise to both specialist and non-specialist practitioners (including GPs and community pharmacists). 

The service is not a substitute for effective multidisciplinary teams (ie, community palliative care teams and GPs consulting with their local hospice pharmacist or community pharmacist resource), but can augment the care provided to patients and support healthcare professionals, regardless of the setting. 

Valuable resource 

In addition to supporting specialists in palliative medicines nationally, Palliative Meds Info aims to also provide a valuable resource to healthcare professionals who infrequently care for palliative care patients and in this way, helps to address regional inequalities in the availability of expertise. 

Supporting healthcare professionals in making informed treatment decisions when managing pain and addressing symptom problems contributes to the improved quality-of-life for both the patient and their family. 

Since the service was launched in 2009, enquiries have been received from professionals working with patients’ care needs in different settings, including hospitals, hospices, community palliative care teams, palliative care specialists, GPs, and community pharmacists throughout the country. The service has built up an extensive database of more than 5,000 enquiry responses. Trends in enquiries help identify topics for which guides are required and these are published as guidance documents on the Palliative Meds Info website.  

Queries 

A wide range of different and patient-specific queries are received and each response is tailored to the patient and their clinical setting. The urgency of each query is discussed with the enquirer so that the service can meet the needs of each patient. If the enquiry is particularly complex, the service will provide initial verbal, informal advice and provide a more detailed written response after reviewing the evidence in greater detail. 

An evaluation of enquiries received between March 2010-March 2019 showed that the largest proportion of enquiries, 45.5 per cent, were received from pharmacists in hospital, hospice and community pharmacy practice, who often refer queries from medical and nursing colleagues locally. The second-largest group were nurses, either in hospital, hospice, nursing home or community practice, from whom 35.2 per cent of all enquiries were received. Doctors, including GPs, NCHDs and consultants, of which the largest group was medical consultants, formed 16.4 per cent of those submitting enquiries to the service over the years. Approximately two-thirds of all enquiries came from specialist palliative care professionals, as there is a much greater awareness of the service amongst the palliative care community.

The website provides out-of-hours access to Palliative Meds Info resources, hosting information on symptom management, opioid conversions, non-opioid analgesic options, topical preparations, mouth care, medicines administered by continuous subcutaneous infusions, and practical information on access to medicines used in palliative care in the community. In addition, the service publishes regular newsletter bulletins that are available by email.

Palliative Meds Info operates five days a week with a dedicated phone line and email address for receiving queries. Enquiries can be made by telephone between 9am and 4pm, Monday–Friday, except public holidays. An answering service records a phone message outside of these times. 

Tel: +353 (0)1 4912578. Email: palliativemedsinfo@olh.ie.  Palliative Meds Info is committed to upholding the core values of Our Lady’s Hospice and Care Services and to the delivery of integrated palliative care services in the community and other healthcare settings. 

To find out more information on the service, visit www.olh.ie/our-services/palliative-care/palliative-meds-info/. To sign up to receive the newsletter bulletins, email palliativemedsinfo@olh.ie.