ArticleAge and ageing2022
Simultaneously reassuring and unsettling: a longitudinal qualitative study of community anticipatory medication prescribing for older patients.
Article in Age and ageing, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Accessing and Administering Anticipatory Medications for Community End-of-Life Symptom Control: A Qualitative Focus Group Study.Journal of clinical nursing · 2026Article
- Mapping patient journeys: Exploring patient and informal carer experiences of injectable anticipatory medication care in the community to identify opportunities for practice improvements.Palliative medicine · 2026Article
- Setting research priorities for palliative and end-of-life care: a James Lind Alliance Priority Setting Partnership Refresh.BMJ open · 2026Article
- Learning from end-of-life injectable medication patient safety incidents in the community: a mixed-methods analysis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Article
- Multiple points of system failure underpin continuous subcutaneous infusion safety incidents in palliative care: A mixed methods analysis.Palliative medicine · 2025Article
- Anticipatory prescribing of injectable controlled drugs (ICDs) in care homes: a qualitative observational study of staff role, uncertain dying and hospital transfer at the end-of-life.BMC geriatrics · 2024Observational
- The financial costs of anticipatory prescribing: A retrospective observational study of prescribed, administered and wasted medications using community clinical records.Palliative medicine · 2023Observational
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
backgroundThe prescription of injectable anticipatory medications is widely accepted by clinicians to be key in facilitating effective last-days-of-life symptom control. Community end-of-life care and admission avoidance is particularly strongly advocated for older patients. However, patient and informal caregiver views and experiences of anticipatory medication have been little studied to date.
objectiveTo understand older patients', informal caregivers' and clinicians' views and experiences of the prescribing and use of anticipatory medications.
designQualitative study.
settingPatients' homes and residential care homes.
participantsPurposive sample of six older patients, nine informal caregivers and six clinicians.
methodsMulti-perspective, longitudinal interview study based on 11 patient cases. Semi-structured interviews (n = 28) were analysed thematically.
resultsThree themes were identified: (i) living in the present whilst making plans: anticipatory medications were used by clinicians as a practical tool in planning for uncertainty, while patients and informal caregivers tried to concentrate on living in the present; (ii) anticipation of dying: it was rare for patients and informal caregivers to discuss explicitly the process and experience of dying with clinicians; and (iii) accessing timely care: the use of anticipatory medications generally helped symptom control. However, informal caregivers reported difficulties in persuading nurses to administer them to patients.
conclusionsAnticipatory medications are simultaneously reassuring and a source of unease to older patients and their informal caregivers. Prescriptions need careful discussion and tailoring to their preferences and experience. Nurses' decisions to administer medication should consider informal caregivers' insights into patient distress, especially when patients can no longer communicate their needs.
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