Researchers: Sarah Thompson, Dr Ben Bowers
Funders: NIHR Applied Research Collaboration East of England Research Fellowship
Partner institutions: Hertfordshire Community NHS Trust; NIHR Applied Research Collaboration East of England
Start date: 01/07/2025
End date: 01/08/2026
Project summary:
Community nurses and family carers are pivotal in the delivery of end-of-life care, particularly in relation to the administration of anticipatory medications during last days-of-life care for symptom relief. However, family carers can feel their insights into their relative’s symptoms are not always considered in decisions to use injectable medications. Despite being considered best practice, there remains scant empirical research or evidence-based tools that provide a sound basis that supports clinicians to make shared decisions during last days of life care. A shared decision-making aid tool has been previously co-designed and rolled out across a local Trust as a service innovation to promote more shared-decision making, including asking the patient’s permission to allow people important to them to advocate their needs when they are no longer able to.
This qualitative focus group study will explore community nurses’ views and experiences of using the shared decision aid tool to see if it has increased their confidence in assessing whether to administer anticipatory medication, explore any limitations of the tool and how it might be best refined.
Project aims:
- To understand community nurses’ views and experiences of using the decision aid tool.
- To explore whether the tool fosters a shared decision-making approach when using anticipatory medication.
Project impact:
Community nurses’ perspectives will be used to help review and refine the tool and its associated training within local practice. This is also the first step in seeing if this local service innovation is helpful and may have wider applicability in other community healthcare settings.
Further information, references, publications and presentations
Bowers B, Pollock K, Wilkerson I, Massou E, Brimicombe J, Barclay S. Administering injectable medications prescribed in the anticipation of the end of life in the community: A mixed-methods observational study. International Journal of Nursing Studies 2024. Available Online First
Bowers B, Pollock K, Barclay S. Simultaneously reassuring and unsettling: a longitudinal qualitative study of community anticipatory medication prescribing for older patients. Age and Ageing 2022. 51(12): afac293
Enhancing Anticipatory Prescribing in End of Life Care Research Repository. 2024.