Researchers: Joodi Mourhli, Dr Ben Bowers, Dr Rosanna Fennessy, Prof. Kristian Pollock, Prof. Andrew Carson-Stevens, Prof. John Clarkson, Prof. Stephen Barclay.
Funders: Wellcome Trust Early Career Award [Ben Bowers]. NIHR Applied Research Collaboration Affiliated Study
Partner institutions: University of Nottingham; Engineering Department, University of Cambridge; Cardiff University; Cambridgeshire and Peterborough NHS Foundation Trust
Start date: 01/08/2025
End date: 01/08/2026
Project summary:
Access to timely injectable medications can be an essential component of effective last-days-of-life symptom control. For many patients and carers, once they have the injectable medication available at home, they also need to be successful in navigating complex healthcare systems and mobilise professional help to come and administer (use) injections when needed. Dying patients and their families can find accessing this care particularly problematic and frustrating, yet there is little research seeking to understand their experiences and how systems for using injectable medications can be improved. This study explores how patients and family carers navigate community healthcare systems to ensure injectable medications are administered, using qualitative data from 15 patient-centred cases where injectable medications were prescribed (data collected 2024-2025).
Project aims:
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To understand how patients and family carers navigate community healthcare systems to ensure prescribed injectable end-of-life medications are administered (used) when needed.
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To identify were and how systems for using injectable medications can be improved.
Project impact:
The project seeks to highlight what works well and can be improved in current service provision to ensure responsive, personalised and effective care. We will provide new insights into the accessibility and helpfulness of current systems for using injectable medication, particularly from dying patients’ and their families’ perspectives, highlighting priority areas for improving practice. This evidence will inform structural changes in current systems for using injectable medications across community healthcare providers.
Further information, references, publications and presentations:
Wellcome Early Careers Award Project (Dr Ben Bowers)
Madden B, Bowers B. Sorted: an experimental interpretive poetry piece on injectable medications care at the end of life. Journal of Research in Nursing 2025; Online First.
Bowers B, Gwyn S, Yardley S, Hellard S, Clarkson J, McFadzean IJ, Pollock K, Barclay S, Carons-Stevens A. Learning from end-of-life injectable medication patient safety incidents in the community: a mixed-methods analysis. British Journal of General Practice 2025; Online First
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; Online First
Bowers B, Antunes BCP, Etkind S, Hopkins S, Winterburn I, Kuhn I, Pollock K, Barclay S. Anticipatory prescribing in community end-of-life care: systematic review and narrative synthesis of the evidence since 2017. BMJ Supportive & Palliative Care 2023. 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.