{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T17:34:59Z","timestamp":1786469699914,"version":"build-2736575974"},"reference-count":33,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Palliative care patients experience complex symptoms requiring varied pharmacological management. Medication choice depends on the underlying aetiology of symptoms, guideline recommendations, clinician preference and medication availability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The aim of this study was to canvass the views of practising Australian and New Zealand medical practitioners practising palliative care\u00a0regarding the medications they perceive to be essential for managing prevalent end\u2010of\u2010life symptoms, in an update to a previous clinician survey conducted in 2000. This study also canvassed respondents\u2019 views on whether patients experienced difficulties accessing these medications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross\u2010sectional survey was conducted in 2022 among current members of the Australian and New Zealand Society of Palliative Medicine (ANZSPM). The questionnaire explored ideal pharmacological management for 19 different symptoms experienced at the end of life. A descriptive analysis of results was calculated in SPSS version 28.0.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Survey reponses were received from 13.5% of ANZSPM members. For most symptoms (n = 70), a large number of medications were listed as essential. The most concordant first\u2010ranked medications included hyoscine butylbromide for noisy breathing (48.8%), benzodiazepines for breathlessness (nominated by respondents as a class, 41.2%), dexamethasone for cachexia (36.4%) and morphine for cough (35.5%). Respondents most frequently indicated there was no essential medication for oral ulceration, dry mouth, delirium and anorexia. Lidocaine for oral ulceration was ranked the most difficult for patients to access in the community (85.7%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There remains various opinions on essential medications for palliative care. This suggests the need for ongoing research to reach an evidence\u2010based consensus for clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/imj.70473","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T07:36:12Z","timestamp":1781163372000},"page":"1361-1368","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Essential medications in palliative care: an updated survey of Australian and New Zealand medical practitioners practising palliative care"],"prefix":"10.1111","volume":"56","author":[{"given":"Jack","family":"Power","sequence":"first","affiliation":[{"name":"Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health University of Technology Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6121-5409","authenticated-orcid":false,"given":"Tim","family":"Luckett","sequence":"additional","affiliation":[{"name":"Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health University of Technology Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9876-9368","authenticated-orcid":false,"given":"Richard","family":"McNeill","sequence":"additional","affiliation":[{"name":"Department of Palliative Care Christchurch Hospital  Christchurch New Zealand"},{"name":"Department of Medicine University of Otago  Dunedin New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Currow","sequence":"additional","affiliation":[{"name":"Flinders Ageing Alliance Flinders University  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7385-3739","authenticated-orcid":false,"given":"Amanda","family":"Landers","sequence":"additional","affiliation":[{"name":"Palliative Care, Department of Medicine University of Otago  Christchurch New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory B.","family":"Crawford","sequence":"additional","affiliation":[{"name":"School of Medicine Adelaide University  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Slavica","family":"Kochovska","sequence":"additional","affiliation":[{"name":"Flinders Ageing Alliance Flinders University  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Good","sequence":"additional","affiliation":[{"name":"Department of Palliative Care St Vincent's Private Hospital  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Boyley","sequence":"additional","affiliation":[{"name":"Department of Palliative Care Royal North Shore Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sungwon","family":"Chang","sequence":"additional","affiliation":[{"name":"Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health University of Technology Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Mounsey","sequence":"additional","affiliation":[{"name":"Department of Palliative Care Barwon Health  Geelong Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,11]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11096-015-0094-3"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/17425255.2016.1179281"},{"key":"e_1_2_8_4_1","volume-title":"WHO Model List of Essential Medications","author":"Organization WH","year":"2023"},{"key":"e_1_2_8_5_1","first-page":"261","article-title":"What are the essential medications in palliative care? A survey of Australian palliative care doctors","volume":"35","author":"Good PD","year":"2006","journal-title":"Aust Fam Physician"},{"key":"e_1_2_8_6_1","unstructured":"Australian Government Department of Health.Phaemaceutical benefits scheme;2024."},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.6.3.e34"},{"key":"e_1_2_8_8_1","article-title":"Opioids for cancer pain: an overview of Cochrane reviews","volume":"7","author":"Wiffen PJ","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_9_1","unstructured":"National Institute for Health and Care Excellence Guidelines.Palliative Care for Adults: Strong Opioids for Pain Relief (CG140). London: NICE;2016."},{"key":"e_1_2_8_10_1","volume-title":"Palliative Care: Pharmacological Management of Pain in Palliative Care","author":"Therapeutic Guidelines Limited","year":"2024"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.12937"},{"key":"e_1_2_8_12_1","article-title":"High\u2010dose opioids for chronic non\u2010cancer pain: an overview of Cochrane reviews","volume":"3","author":"Els C","year":"2023","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-023-40637-8"},{"key":"e_1_2_8_14_1","article-title":"Pregabalin for neuropathic pain in adults","volume":"1","author":"Derry S","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjspcare-2014-000699"},{"key":"e_1_2_8_16_1","article-title":"Gabapentin for chronic neuropathic pain in adults","volume":"6","author":"Wiffen PJ","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_17_1","article-title":"Oral paracetamol (acetaminophen) for cancer pain","volume":"7","author":"Wiffen PJ","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0265-2023"},{"key":"e_1_2_8_19_1","article-title":"Benzodiazepines for the relief of breathlessness in advanced malignant and non\u2010malignant diseases in adults","volume":"10","author":"Simon ST","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00335-2024"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/esmoopen-2020-001038"},{"key":"e_1_2_8_22_1","article-title":"Drug therapy for symptoms associated with anxiety in adult palliative care patients","volume":"5","author":"Salt S","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_23_1","article-title":"Interventions for noisy breathing in patients near to death","volume":"2008","author":"Wee B","year":"2008","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.14785"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-82120-8"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-018-4404-8"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-029942"},{"key":"e_1_2_8_28_1","article-title":"Laxatives for the management of constipation in people receiving palliative care","volume":"2015","author":"Candy B","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2022.09.015"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2016.7491"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.23970\/AHRQEPCCER219"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/02692163211022183"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-019-05229-7"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.2003.01562.x"}],"container-title":["Internal Medicine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.70473","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/imj.70473","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.70473","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T16:42:46Z","timestamp":1786466566000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/imj.70473"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,11]]},"references-count":33,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1111\/imj.70473"],"URL":"https:\/\/doi.org\/10.1111\/imj.70473","archive":["Portico"],"relation":{},"ISSN":["1444-0903","1445-5994"],"issn-type":[{"value":"1444-0903","type":"print"},{"value":"1445-5994","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,11]]},"assertion":[{"value":"2025-12-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}