For Fern Beschi, becoming a Palliative Care Pharmacist was the natural intersection of her lifelong passion for science and deep desire to help others. From early experiences in aged care as a teenager to her current role at Calvary Mater Newcastle, Fern’s career has been shaped by a profound respect for compassionate, patient-centred care at the end of life.
“Working in palliative care has taught me that making the best of the time we have looks different for everyone,” she says. “The role of medicines is not just to manage symptoms, but to help people feel well enough to live their lives, on their terms.”
In palliative care, standard methods of medication delivery may not always be suitable. For people facing life-threatening illnesses symptoms like severe nausea, vomiting, or difficulty swallowing can make taking medicines by mouth very difficult. In these cases, clinicians often rely on continuous subcutaneous infusions (CSCI) - small, portable devices that deliver medication just under the skin through a cannula. These devices can ease discomfort, lower infection risk, and help people stay in the place they often want to be most: at home. However, most medications weren’t designed for this type of delivery, and when multiple drugs are mixed in a single CSCI, there’s limited data on how stable or compatible those combinations really are.
With support from a NSW Regional Cancer Research Network (NSWRCRN) Clinician Fellowship, Fern is working to address this evidence gap. Her current project looks at levetiracetam (LEV), a widely used antiepileptic drug for patients with primary or secondary brain cancers. LEV is often preferred because, unlike older seizure medications, it doesn’t cause heavy sedation, helping patients stay awake, alert, and connected with their loved ones. However, there’s a problem: LEV isn’t typically delivered through continuous subcutaneous infusions (CSCIs), and there’s no lab-tested data on its stability or compatibility when mixed with other pain medications in these pumps. Right now, patients usually receive it through 15-minute hospital infusions, twice a day - an approach that limits comfort and independence. Fern’s research aims to change that, generating the data needed to confirm whether LEV remains stable and effective when combined with other drugs in a single CSCI. The goal is for safer, simpler medication management that supports people to live well, wherever they are.
To inform her initial work and laboratory testing, Fern conducted a large, national survey of palliative care clinicians, identifying how LEV is being used in real-world practice, and which drug combinations are most relevant to test. The results confirmed LEV is widely use in subcutaneous infusions, and morphine and hydromorphone emerged as priority combinations for stability testing. Now, Fern is taking that insight into the lab. Using advanced techniques, such as high-performance liquid chromatography (HPLC), she’s putting these drug combinations to the test – examining how they hold up over time and under different conditions, including temperatures that reflect the realities of the Australian climate. Her aim is to build solid, practical evidence that supports safer, more effective medication delivery for patients when it matters most.
While Fern’s research doesn’t involve direct patient contact, the impact is deeply patient-focused. By validating the safety of LEV in continuous subcutaneous infusions, her work could improve seizure management in people with brain cancer - supporting more consistent care, especially for those living with epilepsy and cancer, and helping more patients remain safely at home.
This could be a game-changer, particularly in rural and remote areas, where reduced nursing visit frequency and longer travel distances make hospital-based care more challenging for patients. ‘This work has the potential to reduce unnecessary hospital admissions and lessen the burden on carers and community services,” Fern explains.
Beyond this project, Fern is also exploring medication stability in extended-duration infusions, which could allow for longer-lasting CSCIs and reduce the need for daily nursing or hospital visits.
“Ultimately, this is about giving people more freedom—more time with family, less disruption, and more dignity in how they spend the time they have,” she says.
Working out of Newcastle’s Calvery Mater Hospital, Fern credits the supportive clinical team around her for encouraging her leap into research. “I would never have pursued higher degree research before receiving a NSWRCRN Clinician Fellowship” she says. “It's my deep belief that the people we treat in palliative care deserve safe, effective medicines—and that’s what drives my passion for research”.