Anticipatory Prescribing in Terminal Care Study
Research type
Research Study
Full title
Anticipatory Prescribing in Terminal Care Study (APT Study)
IRAS ID
254483
Contact name
Stephen Barclay
Contact email
Sponsor organisation
University of Cambridge
Clinicaltrials.gov Identifier
20181113, Royal College of Nursing (RCN) Foundation Professional Bursary Number; NIHR SPCR-2018-146, National Institute for Health Research School for Primary Care Research
Duration of Study in the UK
1 years, 11 months, 31 days
Research summary
Anticipatory prescribing (AP) is the prescription and dispensing of injectable medications to a named patient, in advance of clinical need, for administration by nurses or General Practitioners (GPs) if symptoms arise in the last days of life. Wide-spread practice in the UK, AP seeks to reduce crisis hospital admissions and enhance symptom control at home. AP is endorsed by national policy and is considered best practice, but there are concerns regarding its safety and the practice of AP has never been subject to detailed research and scrutiny. We do not know which patients could or do benefit from AP.
Our retrospective medical records review study will provide detailed data on the frequency of issuing and using AP across a range of illnesses for patients in the community at the end of life. We will examine the AP practice for 360 diseased patients registered with 12 GP practices in Cambridgeshire and Hertfordshire. The key inclusion criteria are: patients aged 18 or over registered with participating GP practices at time of death; patients recorded as having home or residential care home as their permanent residence in their final month of life. The key exclusion criteria are: death by trauma or suicide; documented objection to records being used for research. In each recruited practice we will summarise the AP care received by the 30 most recently deceased eligible patients over their final 12 months of life using GP and community nursing electronic and paper records.
Anonymised data will be analysed by the research team to identify AP patterns and differences. Findings will be shared widely to local service providers and the public to help inform end of life practice developments and interprofessional team working. This study is part of a funded NIHR School for Primary Care Research PhD studentship.
REC name
East of England - Cambridge South Research Ethics Committee
REC reference
19/EE/0012
Date of REC Opinion
8 Mar 2019
REC opinion
Further Information Favourable Opinion