University Hospital Bonn, GermanyMalteser Hospital Bonn/Rhein-Sieg
Meet Gisela
50 years, cancer left eye 19 years agorecurrent cancer, metastases lung, liver, bone
Severe pain:radiotherapy, opioid
Readmission after 8 weeks
Severe pain: opioid fentanyl 400 µg/h, morphin 60 mg prn
Died in hospice after 3 weeks
University Hospital Bonn, GermanyMalteser Hospital Bonn/Rhein-Sieg
Meet William, Mulago Hospital, KampalaUganda
University Hospital Bonn, GermanyMalteser Hospital Bonn/Rhein-Sieg
Meet the Palliative Care TeamJinja Hospice, Uganda
University Hospital Bonn, GermanyMalteser Hospital Bonn/Rhein-Sieg
Meet Dr. Charmaine BlanchardChris Baragwanath Hospital, SowetoSouth Africa
University Hospital Bonn, GermanyMalteser Hospital Bonn/Rhein-Sieg
Soweto, South Africa
University Hospital Bonn, GermanyMalteser Hospital Bonn/Rhein-Sieg
Soweto, South Africa
University Hospital Bonn, GermanyMalteser Hospital Bonn/Rhein-Sieg
Soweto, South Africa
University Hospital Bonn, GermanyMalteser Hospital Bonn/Rhein-Sieg
To identify the most important symptoms in palliative care, taking into account prevalence and associated distress
To identify appropriate pharmacological approaches for management of individual symptoms
To determine effectiveness and safety of identified pharmacological approaches
Essential Medicines in Palliative Care Objectives
University Hospital Bonn, GermanyMalteser Hospital Bonn/Rhein-Sieg
Palliative Care Priorities
ElderlyNursing Home
Dementia
Cancer
HIV / Aids
NeurologicalDiseases: MND
Rabies?
Developed Countries
Developing Countries
Pediatrics
Cardiac FailureLung FailureRenal Failure
MDR TB
University Hospital Bonn, GermanyMalteser Hospital Bonn/Rhein-Sieg Murray et al. BMJ 330 (2005) 1001-11
Trajectories
High function
Low functionDeath
Time
Cancer
MND, heart, lung disease
Frailty, dementia
University Hospital Bonn, GermanyMalteser Hospital Bonn/Rhein-Sieg
Drug Commission of German Medical Board series of systematic reviews commissioned
European Association for Palliative Care guidelines and expert papers from the research network
International Association for Hospice and Palliative Careworldwide expertise, including resource-poor settings
African Palliative Care Associationresearch collaboration
Essential Medicines in Palliative Care Resources
University Hospital Bonn, GermanyMalteser Hospital Bonn/Rhein-Sieg
German guidelines, sys revs
IAHPC expertise
EAPC guidelines
APCA research collaborations
IAHPC Application for EMLMedicine IndicationAmitriptyline NEW: 75 mg tablet DepressionDexamethasone NEW: 4 mg tablet Anorexia
Fatigue Diazepam AnxietyDocusate Sodium ConstipationFluoxetine DepressionHaloperiodol Delirium Hyoscine butylbromide NEW: 10mg/mL injection Respiratory Tract
Secretions Ibuprofen PainLoperamide NEW: 2mg solid oral form DiarrhoeaLorazepam NEW: 1 mg, 2.5 mg tablet AnxietyMetoclopromide Nausea, vomitingMorphine Pain
Dyspnea Senna ConstipationSodium Picosulfate NEW: 7.5 mg/mL oral liquid Constipation
University Hospital Bonn, GermanyMalteser Hospital Bonn/Rhein-Sieg
Accept medicines for adults
Add medicines: hyoscine butylbromide, sodium picosulfate, loperamide
Add formulations
Separate section for palliative care for adults and children
Essential Medicines in Palliative Care Application
