Patients in the last days of life at home or in care homes sometimes need fast access to medications to ease their symptoms but new approaches are needed to ensure this happens, say Dr Ben Bowers (University of Cambridge Primary Care Unit) and colleagues in their BMJ Opinion, published on May 16th.
For patients dying in the community, rapid and tailored access to last-days-of-life medications can be difficult to organise, although these medications can help avert preventable suffering in the final days and hours of life.
Dr Bowers and his co-authors, who are all experts in end-of-life care, propose four additional options to help ensure ready access to medications for all patients who need them.
- resource some community pharmacies to supply end-of-life medications 24 hours a day, seven days a week;
- enable emergency paramedics to carry end-of-life medication stocks that they can administer to dying patients;
- trial community healthcare services and nursing homes holding a stock of end-of-life medications;
- change pharmaceutical regulations to permit end-of-life medications prescribed for one care home resident to be repurposed for another resident, following a medical assessment and individualised prescription (as was permitted during the pandemic).
The research team conclude: “These options will all need careful piloting and robust evaluation of their clinical effectiveness, safety, unintended consequences and patients’ and families’ views and experiences of care.
Taken together, they may not only considerably reduce medication wastage but most importantly help to avoid preventable suffering in the final days and hours of life.”
Read the BMJ article
The BMJ opinion piece was published at 8am on Tuesday 16 May 2023
Ben Bowers, Paul Howard, Bella Madden, Kristian Pollock, Stephen Barclay: Is end-of-life anticipatory prescribing always enough? Opinion, BMJ, 16 May 2023
About the University of Cambridge’s Primary Care Unit
This research was conducted at the Primary Care Unit, which sits within the Department for Public Health and Primary Care at the University of Cambridge. We aim to reduce the burden of ill health through our research and teaching. We work to identify and target behaviours that lead to chronic disease, improve the early detection of disease and improve the quality of health services.
The mission of the University of Cambridge is to contribute to society through the pursuit of education, learning and research at the highest international levels of excellence. To date, 109 affiliates of the University have won the Nobel Prize.
Founded in 1209, the University comprises 31 autonomous Colleges and 150 departments, faculties and institutions. Cambridge is a global university. Its 19,000 student body includes 3,700 international students from 120 countries. Cambridge researchers collaborate with colleagues worldwide, and the University has established larger-scale partnerships in Asia, Africa and America.
The University sits at the heart of the ‘Cambridge cluster’, which employs more than 61,000 people and has in excess of £15 billion in turnover generated annually by the 5,000 knowledge-intensive firms in and around the city. The city publishes 316 patents per 100,000 residents.