PT  - JOURNAL ARTICLE
AU  - Bárbara Antunes
AU  - Ben Bowers
AU  - Isaac Winterburn
AU  - Michael P Kelly
AU  - Robert Brodrick
AU  - Kristian Pollock
AU  - Megha Majumder
AU  - Anna Spathis
AU  - Iain Lawrie
AU  - Rob George
AU  - Richella Ryan
AU  - Stephen Barclay
TI  - Anticipatory prescribing in community end-of-life care in the UK and Ireland during the COVID-19 pandemic: online survey
AID  - 10.1136/bmjspcare-2020-002394
DP  - 2020 Sep 01
TA  - BMJ Supportive & Palliative Care
PG  - 343--349
VI  - 10
IP  - 3
4099  - http://spcare.bmj.com/content/10/3/343.short
4100  - http://spcare.bmj.com/content/10/3/343.full
SO  - BMJ Support Palliat Care2020 Sep 01; 10
AB  - Background Anticipatory prescribing (AP) of injectable medications in advance of clinical need is established practice in community end-of-life care. Changes to prescribing guidelines and practice have been reported during the COVID-19 pandemic.Aims and objectives To investigate UK and Ireland clinicians’ experiences concerning changes in AP during the COVID-19 pandemic and their recommendations for change.Methods Online survey of participants at previous AP national workshops, members of the Association for Palliative Medicine of Great Britain and Ireland and other professional organisations, with snowball sampling.Results Two hundred and sixty-one replies were received between 9 and 19 April 2020 from clinicians in community, hospice and hospital settings across all areas of the UK and Ireland. Changes to AP local guidance and practice were reported: route of administration (47%), drugs prescribed (38%), total quantities prescribed (35%), doses and ranges (29%). Concerns over shortages of nurses and doctors to administer subcutaneous injections led 37% to consider drug administration by family or social caregivers, often by buccal, sublingual and transdermal routes. Clinical contact and patient assessment were more often remote via telephone or video (63%). Recommendations for regulatory changes to permit drug repurposing and easier community access were made.Conclusions The challenges of the COVID-19 pandemic for UK community palliative care has stimulated rapid innovation in AP. The extent to which these are implemented and their clinical efficacy need further examination.