RT Journal Article
SR Electronic
T1 35 Carer-administration of as-needed sub-cutaneous medication for breakthrough symptoms in homebased dying patients: a uk study (CARIAD)
JF BMJ Supportive & Palliative Care
JO BMJ Support Palliat Care
FD British Medical Journal Publishing Group
SP A360
OP A360
DO 10.1136/bmjspcare-2017-001407.35
VO 7
IS 3
A1 Clare Wilkinson
A1 Marlise Poolman
A1 Jessica Roberts
A1 Bee Wee
A1 Julia Hiscock
A1 Dyfrig Hughes
A1 Annmarie Nelson
A1 Paul Perkins
A1 Rosalynde Johnstone
A1 Liz Reymond
A1 Betty Foster
A1 Julie O’Connor
A1 Sian Jones
A1 Zoe Hoare
A1 Rossela Roberts
A1 Anthony Byrne
A1 Sue Healy
A1 Penney Lewis
YR 2017
UL http://spcare.bmj.com/content/7/3/A360.2.abstract
AB Introduction Whilst the majority of seriously ill people express a wish to die at home (79%), only half of those achieve this. The likelihood of patients remaining at home often depends on availability of able and willing informal carers who take on numerous care tasks, often including the responsibility of assisting patients with oral medications. The role of carers administering subcutaneous injections is not widespread practice in the UK, but has proven to be key in achieving home death in other countries.Aim To determine if carer-administration of as-needed subcutaneous medication for four breakthrough symptoms (pain, nausea, restlessness and noisy breathing) in homebased dying patients is feasible and acceptable in the UK.Methods One hundred adult patients in the last weeks of life who are likely to lose the oral route and have expressed a preference to die at home will be recruited with their carers to an external randomised pilot trial across three UK sites (North Wales, South Wales and Gloucestershire). Carers randomised to the intervention arm will receive a manualised training package adapted from an existing Australian model and delivered by local district nursing teams. Dyads in the control arm will receive usual care.Results The main outcomes of interest will be feasibility, acceptability, recruitment rates, attrition and selection of the most appropriate outcomes measures.Conclusion Findings will inform a definitive Phase III randomised controlled trial.The study is funded by the National Institute for Health Research (HTA project 15/10/37). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.