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Community prescribing for cancer patients at the end of life: a national study
  1. Gabrielle Emanuel1,
  2. Julia Verne2,
  3. Karen Forbes3,
  4. Luke Hounsome1 and
  5. Katherine E Henson1
  1. 1 National Disease Registration Service, Public Health England, London, UK
  2. 2 National End of Life Care Intelligence Network, Public Health England, Bristol, UK
  3. 3 Bristol Medical School, University of Bristol, Bristol, UK
  1. Correspondence to Dr Katherine E Henson, National Disease Registration Service, Public Health England, London SE1 8UG, UK; katherine.henson{at}


Background Good end-of-life care is essential to ensure dignity and comfort in death. To our knowledge, there has not been a national population-based study in England of community prescribing of all drugs used in end-of-life care for patients with cancer.

Methods 57 632 people who died from malignant cancer in their own home or in a care home in 2017 in England were included in this study. National routinely collected data were used to examine community prescriptions dispensed for drugs for symptom control and anticipatory prescribing by key sociodemographic factors in the last 4 months of life.

Results 94% of people who died received drugs to control their symptoms and 65% received anticipatory prescribing. Prescribing increased for the symptom control drug group (53% to 75%) and the anticipatory prescribing group (4% to 52%) over the 4-month period to death.

Conclusions Most individuals who died of cancer in their own home or a care home were dispensed drugs commonly used to control symptoms at the end of life, as recommended by best-practice guidance. Lower prescribing activity was found for those who died in a care home, highlighting a potential need for improved end-of-life service planning.

  • terminal care
  • cancer

Data availability statement

Data are available on reasonable request. Data held by Public Health England can be requested using the Office for Data Release:

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Data availability statement

Data are available on reasonable request. Data held by Public Health England can be requested using the Office for Data Release:

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  • Contributors Conception and design of the work: KEH, GE, LH, JV, KF. Analysis of the data: KEH, GE. Clinical interpretation: JV, KF. All authors made substantial contributions to the interpretation of the findings. All authors contributed to drafting the manuscript or revising it critically for important intellectual content and approved the final version submitted. All authors have agreed to be accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.