Medication management when moving between care settings

When a patient with palliative care needs is moving between care settings, plans for continuing medication supplies should be made before or at the time of the move. Any transition between care (eg from home to hospital) can potentially disrupt a patient’s medication management because the receiving facility may not have their usual medication, or be informed about the patient’s medication needs.

If a patient is transferred from hospital into the community (including to care facilities), communicating with their general practitioner (GP) and local pharmacy is vital to ensure continuity of care.

Contact should be made with the GP to discuss patient care, provide relevant information and coordinate prescribing. GPs may be reluctant to provide prescriptions for a patient if they are not familiar with their medications or current medical situation.

Discussion with the patient’s local pharmacy is important to ensure the pharmacist can provide appropriate medication information and continuity of medication supply. Many injectable items and some opioid formulations are not routinely stocked by community pharmacies and may take time to order. Consider the cost to the patient; medications that are not subsidised on the Pharmaceutical Benefits Scheme (PBS) can be expensive. Seek advice from a pharmacist or specialist palliative care service if there are difficulties in obtaining medications.

When a patient is admitted to a facility (eg hospital, palliative care unit), or transferred from one facility to another, consider which medications they will need to take with them. Although palliative care units may stock medications commonly prescribed for symptom management, they may not keep medications for other conditions the patient may have (eg diabetes, heart disease, Parkinson disease). Ask the patient to take their own medications with them to ensure ongoing supply. Contact the facility for advice if unsure which medications should go with the patient or if they do not have their own supply.