Is end-of-life anticipatory prescribing always enough?

Dying in pain or distress is a cause of considerable concern for patients, their loved ones, and clinicians.1234 Helping patients to die in comfort is an essential goal of end-of-life care. During out-of-hours periods, which make up the majority of time, sourcing medical assessments, prescriptions, and drugs from pharmacies can be challenging and at times is not possible.34 Consequently, anticipatory prescribing of injectable drugs ahead of possible need is recommended good practice internationally to optimise timely symptom control in the community and prevent crisis hospital admissions.56 Anticipatory prescribing is a well established, clinician-led solution to overcome difficulties in rapidly accessing drugs in the community. But this solution is not always put in place and additional options are required.Injectable anticipatory drugs are typically prescribed as needed for five common and distressing symptoms: pain, breathlessness, nausea and vomiting, agitation, and noisy respiratory tract secretions.7 The drugs, including opioids and sedatives; equipment; and…
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