Accessing and Administering Anticipatory Medications for Community End‐of‐Life Symptom Control: A Qualitative Focus Group Study

AIM: To understand healthcare professionals' perspectives of what works well and what can be improved in the supply and administration of anticipatory medications at the end of life in the community. DESIGN: Qualitative interpretive study using focus groups. METHODS: Semi-structured focus groups included healthcare professionals with experience of using anticipatory medications, and public contributors with lived experiences of relatives' end-of-life care. Participants' demographic information was elicited in a brief questionnaire. Transcripts were analysed inductively using thematic analysis. Data were collected in September 2022. SETTING AND PARTICIPANTS: Eight focus groups involved 58 UK-based participants. Each group included people with a variety of professional roles from diverse geographical areas, and public contributors with relevant lived experiences. RESULTS: The administration of anticipatory prescriptions was widely perceived to be a valuable intervention, but extensive operational challenges were identified, with three interconnected themes arising from the data: (a) Communication between healthcare teams; (b) Intuitive documentation; (c) Accessibility of medications. Addressing these challenges was perceived to be onerous, particularly for nurses and families. CONCLUSIONS: Operational barriers to the timely and appropriate administration of anticipatory medications risk were perceived as adversely affecting patient care and patients' and families' experiences. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: System-level improvements are needed to streamline care processes and ensure equitable, appropriate, and timely access to end-of-life symptom control medications in the community. REPORTING METHOD: This study adheres to relevant EQUATOR guidelines and follows the appropriate Standards for Reporting Qualitative Research (SRQR). PATIENT OR PUBLIC CONTRIBUTION: Our Public and Clinician Advisory Group helped shape questions and commented on findings. Focus groups included public participants with lived experience of end-of-life care in the community.