Nov 16, 2021
This episode features Dr Ben Bowers (Primary Care Unit,
Department of Public Health and Primary Care, University of
Cambridge, Cambridge, UK).
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 the 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 days before death
(median 17 days). Anticipatory medications were frequently
prescribed as standardised drugs and doses, and often as part of a
single end-of-life care planning intervention. Patients’ and family
carers’ involvement in prescribing decisions 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 long periods of time may compromise patient
safety unless robust systems are in place to review their continued
appropriateness and safe use.