Researchers: Dr Ben Bower, Emyr Jones (Cardiff University), Phillippa Ashcroft (Marie Curie), Julie Watson (Marie Curie), Amy Dalrymple (Marie Curie)
Funders: Marie Curie
Partner institutions: Marie Curie England, Marie Curie Scotland, Cardiff University, Royal College of Nursing, Abbotsford Care, Royal Pharmaceutical Society
Start date: 01/03/2025
End date: 01/08/2026
Project summary:
Near the end of life, people in care homes often need access to controlled drugs (CDs) to manage distressing symptoms including pain, breathlessness and anxiety. However, residents dying in care homes across the UK can struggle to get timely access to the medicines they need, particularly during out-of-hours. Holding a small number of end-of-life medicines as ‘stock’ that any care home resident could then be given, following a clinician assessment and individualised prescription, could enable more timely access and reduce suffering.
Our online mixed-methods survey study seeks to explore how accessible controlled drugs for palliative and end-of-life care are in UK care homes, and what factors influence this access, from care home staff perspectives. We will gather care home staff suggestions for improving access to controlled drugs, including the potential benefits and risks of holding a centralised stock of end-of-life medicines within care homes.
Project aims:
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To understand current practices in accessing and using controlled drugs in care homes.
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To identify barriers and enablers to the timely access of controlled drugs in care homes.
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To explore care home staff suggestions for improving access to controlled drugs, including the potential benefits and risks of a centralised stock within care homes.
Project impact:
This research will directly inform the policy influencing work of a national partnership of key stakeholders, professional organisations and charities. Ultimately, it may contribute to changes in UK-wide legislation concerning the supply and storage of end-of-life medicines in care homes.
Further information, references, publications and presentations:
Bowers B, Howard P, Madden B, Pollock K, Barclay S. Is end-of-life anticipatory prescribing always enough? British Medical Journal 2023; 381: p1106
Majumder M, Bowers B, Pollock K, Goodman C, Kuhn I, Barclay S. End of life care in UK care homes – controlled drugs: systematic review and narrative synthesis. BMJ Supportive &Palliative Care 2022; 12: 253-261
Antunes B, Bowers B, Winterburn I, et al. Anticipatory prescribing in community end-of-life care in the UK and Ireland during the COVID-19 pandemic: online survey. BMJ Supportive & Palliative Care 2020; 10: 343-349