Unwelcome memento mori or best clinical practice? Community end of life anticipatory medication prescribing practice: A mixed methods observational study
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This episode features Dr Ben Bowers (Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge,\\xa0UK).
The prescribing of injectable anticipatory medications to provide symptom relief in the last days of life is recommended and widespread practice in a number of counties. There is limited research concerning\\xa0the frequency, timing and context of prescriptions.
Half (50.8%) of 329 patients whose deaths were potentially predictable deaths were prescribed anticipatory medications, the timing of prescriptions ranging from 0 to 1212\\u2009days before death (median 17\\u2009days).\\xa0Anticipatory medications were frequently prescribed as standardised drugs and doses, and often as part of a single end-of-life care planning intervention. Patients\\u2019 and family carers\\u2019 involvement in prescribing\\xa0decisions was unclear.
Patient and family preferences for involvement in anticipatory medications prescribing decision-making and their experiences of care warrant urgent investigation. The presence of anticipatory medications for\\xa0long periods of time may compromise patient safety unless robust systems are in place to review their continued appropriateness and safe use.