Supportive and Palliative Care Unit

Supportive and Palliative Care Unit

The Supportive and Palliative Care Unit at Monash Health is a Monash University academic unit focused on excellence of care for patients and their families who have a life limiting illness.
Our unit comprises:

  • 16 bed level-3 inpatient unit with admissions in excess of 600 per annum
  • Bi-disciplinary medical/nursing consult team covering the Monash Health Network and with annual consultations numbering in excess of 1500 per year
  • Oncopain outpatients clinic

The unit is  an accredited palliative medicine registrar training facility with all our physicians being accredited supervisors of the Chapter of Palliative Medicine (Royal Australasian College of Physicians). We also provide undergraduate medical student palliative medicine teaching for Monash University, teaching for resident medical officers, physician training registrars and nursing - undergraduate, post graduate and nurse practitioners.

Available research projects

Our staff

Director

Our Director, Associate Professor Peter Poon is a palliative care physician and Director of Supportive and Palliative Care at Monash Health.  He also has an appointment as consultant palliative care physician with Eastern Palliative Care Association, the largest home based palliative care service in Victoria.

Consultants

  • Dr Michael Franco (Adjunct Associate Professor)
  • Dr Leeroy William (Adjunct Senior Lecturer)
  • Dr Fiona Runacres (Adjunct Lecturer)
  • Dr Jaclyn Yoong (Adjunct Lecturer)
  • Dr Holly Atkinson (Gippsland)
  • Dr Esther Lin (Gippsland)
  • Dr Alison Giles (Gippsland)

Research Fellows

  • Dr Helena Sim
  • Dr Anne Ky

Research Assistant

  • Venesha Rethnam ( Bsc. Hons)

PhD Candidates

  • Dr. Beisi Jiang
  • Liban Abdisalam

Department Administration

  • Linda Jay

Our research focuses

  • Telemedicine
  • Refractory Pain
  • Refractory Symptoms
  • End of Life Care

Current projects

  • Telehealth for Rural Palliative Care; A prospective controlled pilot study of video-consultations for patients & carers of a domiciliary palliative care service (Victorian Cancer Agency Grant).
  • Efficacy of low-dose methadone as an antitussive for patients with malignancy (Bethlehem Griffiths Research Foundation Award).
  • Opioid titration : A new algorithm for opioid selection and titration for cancer patients to challenge current practice.
  • ED ‘Big Data’ in collaboration with Monash University Faculty of Information Technology – Preliminary work being undertaken with Victorian Emergency Department dataset.
  • Vertebroplasty for Cancer Patients: Research in collaboration with the Monash Health Interventional Radiology Department.
  • Oncopain Clinic – First oncological refractory pain clinic in Victoria. Capture research data including pain & symptoms, performance status and QOL, data to assess the effectiveness of the clinic to avert ED presentations and admissions.
  • The changing nature of patients being admitted to Palliative Care units: analysis of patients being admitted within 24-72 hours of death.
  • Effectiveness of Palliative Medicine teaching to undergraduate students: survey results of students on completion of the teaching program and again as junior medical officers at Monash Health.
  • An audit of the effects of ketamine in palliative care patients with refractory pain
  • Caregivers experiences of end of life care for patients in General Medicine
  • Improving utilisation of specialist palliative care services in geriatric and rehabilitation units
  • QT Auditing in Palliative Care Patients on Methadone.

To promote collaborative research and identifying important areas for clinical and translational research our physicians are members of the following bodies:

  • Palliative Care Clinical Network which reports to the Department of Health and assists palliative care consortia state wide in clinical tools, research and clinical policy. An efficacious platform to receive information about prospective areas of required research from consortia and disseminates findings and suggested practice changes. Membership includes: Department of Health Victoria, Palliative Care Consortia managers, Palliative Care Victoria, Clinicians from both rural and metro Victoria and Cabrini Health Palliative Care.
  • Cancer Council Victoria: Palliative Medicine Network – supportive of collaborative research and attended by all key palliative medicine physicians state-wide. Ability to both receive input for areas of required clinical research as well as output to members and their organizations.
  • Victorian Southern Palliative Care Consortia – ability to disseminate research findings into clinical practice and identify areas of required research as membership includes hospital and community palliative care services statewide.
  • Victorian Integrated Cancer Streams
  • Gippsland Regional Palliative Care Consortium (GRPCC)
  • Victorian Palliative Medicine Training Program (VPMTP)
  • Palliative Care Research Network Victoria
  • Australian Lung Trials Group

Recent Publications

  • Jackson, K., Franco, M., William, L., Poon, P. et al. (2013). Ketamine and cancer pain: the reports of my death have been greatly exaggerated. J Clin Oncol 31(10): 1373-1374. (Impact Factor: 18.37)
  • Poon P, Jackson K, Platt T. When managing established osteonecrosis of the jaw, don’t forget the not-infrequent chronic refractory pain. Internal Medicine Journal 2010; 40: 243-244.
  • Poon P. Symptom Control at the End of Life, Proceedings of the 21st Stoke Society of Australia Scientific Meeting, International Journal of Stroke, 2010;6
  • Shaw T, Poon P, Jackson K, William L and Franco M. Transcutaneous drainage of lymphatic fluid-a novel technique for management of peripheral oedema in palliative care. Internal Medicine Journal.  2013, Volume 43, p.28 (Impact Factor: 1.54)
  • K Jackson, C Mooney and J Walker.  “Optimising the mix and match needs and available resources for patients dying in hospital”.  IMJ 2013; 43(3):349-350.
  • K Jackson, M Ashby, D Howell, J Petersen, D Brumley, P Good, M Pisasale, S Wein, R Woodruff. The effectiveness and adverse effects profile of “Burst” Ketamine in refractory cancer pain:  The VCOG PM 1-00 Study.  Journal of Palliative Medicine.  2010: 26(3);176-183.
  • Jackson K, Mooney C, Campbell D.  The Development and Implementation of the “Pathway for Improving the Care of the Dying (PICD)” in General Medical Wards.  IMJ 2009; 39(10):695-699.
  • Franco, M., William, L., Poon, P. and Jackson, K. (2014). Critical Appraisal of Randomised Controlled Trials. J Pain Symptom Manage, 47 (4), e1-2, April 4 2014, doi: 10.1016/j.jpainsymman.2013.11.007 (Impact Factor: 2.601)
  • Merlina Sulistio and Kate Jackson.  “Three weeks from diagnosis to death: the chaotic journey of a long term methadone maintenance patient with terminal cancer”.   JPSM 2013; 46(4):598-602.
  • Franco, M., William, L., Poon, P. and Azad, A. (2014). Dexamethasone for Cancer Related Fatigue. J Clin Oncol, Feb 20, 2014:608-609.  doi: 10.1200/JCO.2013.53.7878 (Impact Factor: 18.37)
  • William L, Non-palliative care staff need to deliver generalist end of life care. BMJ 2014;348:g3426 doi: 10.1136/bmj.g3426
  • Azad, A. and Franco, M. (2013). Non-invasive ventilation for end-of-life oncology patients. The Lancet Oncology 14(6): e199-e200. (Impact Factor: 22.59)
  • Azad, A., Siow, S-F., Tafreshi, A., Moran, J. and Franco, M., (2014) Discharge patterns, survival outcomes and changes in clinical management of hospitalized adult cancer patients with a Do-Not-Resuscitate (DNR) Order. J Palliat Med, 2014 Jul;17(7):776-81. doi: 10.1089/jpm.2013.0554. (Featured Article in July 2014 issue; Impact Factor: 1.891)
  • Franco, M. and Koulaeva, E., (2014) Nasogastric tube insertion followed by intravenous and oral erythromycin in refractory nausea and vomiting secondary to paraneoplastic gastroparesis.  Palliat Med, 28 (7), 986-989, July 1 2014, doi: 10.1177/0269216314528400, (Impact Factor: 2.609)
  • Azad A, Tafreshi A, Siow S-F, Franco M. End-of-Life Care in Oncology Inpatients: Who, Where, How? Journal of Oncology Practice (2013). doi: 10.1200/jop.2013.001005
  • Bostanci A, Horey D, Jackson K, William L, Pittmann L, Ward J, Moore G, Martin P, Hudson P, Philip J. Insights into hospitalisation of advanced cancer patients: a study of medical records. Eur J Cancer Care , 22 April 2015, doi: 10.1111/ecc12295
  • William L, Jackson K, Bostanci A, Ward J, Martin P, Pittman L, Moore G. Diagnosis Matters: the differing clinical trajectories for terminal prostate, lung and haematological cancers.  Aust Fam Physician 2015; 44(6): 187-92
  • Li Y, Jackson K, Slon B, Hardy J, Franco M, William L, Poon P, Coller J, Hutchinson M, Currow D, Somogyi A. CYP2B6*6 allele and age substantially reduce steady-state ketamine clearance in chronic pain patients: no influence on response but on adverse effects. Br J Clin Pharmacol. 2015 Feb 22 doi:10.1111/bc.12614 [Epub ahead of print]
  • Sulistio M, Franco M, William M, Vo A, and Poon P. Hospital Rapid Response Team and Patients with Life Limiting Illness: A Multicentre Retrospective Cohort Study . . Palliative Medicine 2015; 29: 302-309– Awarded Editors Choice
  • Hosking S, Franco M, Poon P, William L. Bilateral cordotomy post-failure of intrathecal analgesia in a palliative care setting. Internal Medicine Journal  8 MAY 2015 DOI: 10.1111/imj.12743
  • L William, M Franco, P Poon. Reaching the masses: using Facebook to explain palliative care (paper accepted Feb 2015 European Journal of Palliative Care)