Anticipatory prescribing for symptom management at the end of life

Illustration by Amy Windridge Distressing symptoms are common in the last days of life and their management needs prompt administration of medications delivered by injection.

In this study we aimed to identify and explore in one to one interviews and focus groups the issues that arise for community health care professionals in relation to the prescribing of subcutaneous midazolam and diamorphine for dying patients in advance of their actual requirement.

Objectives

To begin to identify and understand the potential blocks to and facilitators of the implementation of pre-emptive prescribing as routine care
To gain insight into practical considerations with specific reference to professionals’ perceptions of patient safety
To understand concerns and enthusiasms related to pre-emptive prescribing across the spectrum of health care disciplines
To work towards definition of an appropriate clinical governance framework for their use including protocol, training and audit.

Funder

Primary Care Research Network

Project team

Professor Christina Faull (PI), LOROS
Kate Windridge, Univeristy of Leicester
Michael Hudson, LOROS and now Leicester Partnership Trust, Hospice at Home Team

The study is now complete

Publications

Faull C, Windridge K, Ockleford E, Hudson M 2013. Anticipatory prescribing in terminal care at home: what challenges do community health professionals encounter? BMJ Supportive and Palliative Care 3:91-97.

Illustration by Amy Windridge, and used with her permission.