BMJ supportive & palliative care · 2026
Just-in-case drugs in the dying: home deaths retrospective chart review.
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Rutter Paul, Howard Paul, Clawson Sandra, Gough Molly
Аннотация
OBJECTIVES: To evaluate whether the Isle of Wight (IoW) Just-in-Case (JIC) scheme to supply and administer anticipatory medication to end-of-life patients was performing to an appropriate level of performance.
METHODS: A retrospective chart review was conducted on patients who were considered end of life and who died at home on the IoW during 2022.
RESULTS: JIC medication was prescribed to 88% (n=70/80) of patients. Of these patients, half were administered at least four of the five medicines listed on the IoW JIC scheme. Almost three-quarters (71%, n=50/70) of patients had the standard dosage regimens amended to provide individualised treatment, and 96% (n=67/70) of patients saw some alterations to their ongoing management after initialisation of treatment. The time between prescribing and administration of JIC medication was short.
CONCLUSIONS: The JIC scheme on the IoW allowed patients to receive timely and individualised care. One or more JIC drugs were administered to a higher proportion of patients than in previous studies; further work is required to establish why (eg, the use of a 24/7 home visiting palliative care nursing team in this locality) and whether this led to improved family confidence that symptoms were effectively controlled.
METHODS: A retrospective chart review was conducted on patients who were considered end of life and who died at home on the IoW during 2022.
RESULTS: JIC medication was prescribed to 88% (n=70/80) of patients. Of these patients, half were administered at least four of the five medicines listed on the IoW JIC scheme. Almost three-quarters (71%, n=50/70) of patients had the standard dosage regimens amended to provide individualised treatment, and 96% (n=67/70) of patients saw some alterations to their ongoing management after initialisation of treatment. The time between prescribing and administration of JIC medication was short.
CONCLUSIONS: The JIC scheme on the IoW allowed patients to receive timely and individualised care. One or more JIC drugs were administered to a higher proportion of patients than in previous studies; further work is required to establish why (eg, the use of a 24/7 home visiting palliative care nursing team in this locality) and whether this led to improved family confidence that symptoms were effectively controlled.