| Which drugs are prescribed? | 98 (38%) | 146 (56%) | 17 (7%) | More off-licence drug use #83 CONS. Including non-injectables, for example, buccal midazolam in case no nurse can attend #14 CONS. Changing with availability: hyoscine patch for glycopyrronium #253 CNS.
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| The quantities of drugs prescribed? | 90 (35%) | 137 (53%) | 34 (13%) | Prescribing smaller quantities to preserve stocks #51 CONS. Larger doses for ARDS: may need repeated sooner #127 TRAIN. Continuing normal practice #217 DOC.
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| Drug doses/dose ranges prescribed? | 75 (29%) | 163 (63%) | 23 (9%) | Higher starting doses for distress, especially levomepromazine #241 CONS. Up to 1-hourly if dyspnoea or distress persist #102 CONS Quicker escalation to larger doses for some #99 GP. Wider ranges and more prescribed to cover every eventuality #83 CONS.
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| Arrangements for drugs and supporting documents to be in the home/care home? | 96 (36%) | 135 (52%) | 31 (12%) | Authorisation sheet electronic #240 GP ‘Grab bags' with anticipatory meds available in emergency department #248 CONS. Stores with army to deliver: 'just in case' changed to 'just in time' #134 CONS.
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| Route of administration, especially the sublingual/buccal route? | 122 (47%) | 124 (48%) | 15 (6%) | Oral/buccal routes give patients/relative more control without HCP #84 CONS. Subcutaneous route first, buccal/transdermal use if availability of SC drugs affected #64 CNS. Lorazepam, hyoscine and fentanyl patches alternatives if SC meds not available #5 CONS.
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| Person administering AP drugs, especially family/informal carers or social care colleagues? | 97 (37%) | 136 (52%) | 28 (11%) | Family offered chance to learn if they want to #217 DOC. Care home staff rather than district nurse after phone advice #213 GP. Already have carer administering SC policy #244 CONS.
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| Telephone or other advice and support for AP, including family/social care administration? | 127 (49%) | 113 (43%) | 21 (8%) | Advice line 17:00–21:00. Increased our cover on weekend and Bank Holiday #10 CNS. Decision for AP made on FaceTime #46 OTHER. Much more remote working now; complete change in practice #150 GP.
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| The use of phone or video to support AP practice? | 165 (63%) | 78 (30%) | 18 (7%) | Care now via telephone or video including AP advice #131 DOC. Reduces risk of transmission and aids completion of forms when patient dies #176 GP. Video review to make decision patient is dying; may need visit in person #240 GP.
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| The prescribing of AP medications for patients with non-COVID-related illness? | 63 (24%) | 181 (69%) | 17 (7%) | Any patient could develop COVID, anticipating higher likelihood of agitation #71 TRAIN. Consider non injectables for non-complex #22 CONS. Preparing for how to cope without syringe drivers #150 GP.
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| The use of syringe drivers? | 79 (30%) | 165 (63%) | 17 (7%) | Few patients with COVID need syringe pumps as they die very quickly #240 GP. Most dying patients with COVID easily managed by stat doses #103 CONS. Patches due to equipment and DN resources #39 TRAIN.
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