6784 Paediatric to adult palliative care – is there a prescription for transition?

Objectives The number of children in the UK living with a life-limiting condition is rising year-on-year.1 The average life expectancy associated with many of these conditions also continues to increase and, consequently, more children are surviving into young adulthood and beyond. At around age 16, responsibility for the care of these children starts to transition from paediatric to adult palliative care services. Transition is a complex process requiring coordination and continuity across the many aspects of the multidisciplinary care of the young person2 – to ensure that the patient, those close to them and the many healthcare professionals involved in their care feel empowered and supported throughout. The transition process is therefore continually under review but there is currently limited guidance and education more specifically for the health and social care professionals who look after these young adults with a palliative care requirement during this crucial period of change. One particular theme which is presently rarely addressed is the prescribing and administration of medications in this patient cohort – which can differ quite significantly from those which adult palliative care providers may be more familiar with. Methods To determine which medicines are most frequently prescribed to young adults transitioning or newly fully-transitioned to adult palliative care services, data was obtained from the medication charts of a representative group of these patients from Children's Hospices Across Scotland (CHAS). The medications prescribed to each individual included were documented and classified, in order to identify the drug-types most widely used. Results The classes of drugs found to be most often administered included antiepileptic and antimuscarinic agents, which suggested a high prevalence of seizure activity and spasticity in this patient cohort – symptoms commonly associated with the neurodegenerative conditions with which these patients most often present. Anecdotal evidence suggests that adult palliative care staff often feel somewhat out of their depth with regard to the management of such life-limiting conditions.3 Conclusion The development of educational resources or prescribing training modules for staff highlighting the appropriate use of these drugs in the palliative care setting is therefore warranted – in addition to further guidance surrounding the overall transition process. This would facilitate preparedness and confidence to prescribe and administer medications amongst the adult palliative healthcare professionals adopting responsibility for the care of young adults – and thus ensure that the standard of this care is in- keeping with that which is so brilliantly provided by paediatric palliative care services. References Fraser LK, Gibson-Smith D, Jarvis S, et al. Estimating the current and future prevalence of life-limiting conditions in children in England, 2021. Transition from children's to adults' services for young people using health or social care services NG43, NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE, 2016. Noyes J, Pritchard A, Rees S, et al. Bridging the Gap: Transition from Children's to Adult Palliative Care, 2014.