{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,29]],"date-time":"2026-03-29T06:10:42Z","timestamp":1774764642130,"version":"3.50.1"},"reference-count":40,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2020,6,16]],"date-time":"2020-06-16T00:00:00Z","timestamp":1592265600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Support Palliat Care"],"accepted":{"date-parts":[[2020,6,1]]},"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Anticipatory prescribing (AP) of injectable medications in advance of clinical need is established practice in community end-of-life care. Changes to prescribing guidelines and practice have been reported during the COVID-19 pandemic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims and objectives<\/jats:title><jats:p>To investigate UK and Ireland clinicians\u2019 experiences concerning changes in AP during the COVID-19 pandemic and their recommendations for change.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Online survey of participants at previous AP national workshops, members of the Association for Palliative Medicine of Great Britain and Ireland and other professional organisations, with snowball sampling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two hundred and sixty-one replies were received between 9 and 19 April 2020 from clinicians in community, hospice and hospital settings across all areas of the UK and Ireland. Changes to AP local guidance and practice were reported: route of administration (47%), drugs prescribed (38%), total quantities prescribed (35%), doses and ranges (29%). Concerns over shortages of nurses and doctors to administer subcutaneous injections led 37% to consider drug administration by family or social caregivers, often by buccal, sublingual and transdermal routes. Clinical contact and patient assessment were more often remote via telephone or video (63%). Recommendations for regulatory changes to permit drug repurposing and easier community access were made.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The challenges of the COVID-19 pandemic for UK community palliative care has stimulated rapid innovation in AP. The extent to which these are implemented and their clinical efficacy need further examination.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjspcare-2020-002394","type":"journal-article","created":{"date-parts":[[2020,6,16]],"date-time":"2020-06-16T23:42:12Z","timestamp":1592350932000},"page":"343-349","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":38,"title":["Anticipatory prescribing in community end-of-life care in the UK and Ireland during the COVID-19 pandemic: online survey"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1655-7391","authenticated-orcid":false,"given":"B\u00e1rbara","family":"Antunes","sequence":"first","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6772-2620","authenticated-orcid":false,"given":"Ben","family":"Bowers","sequence":"additional","affiliation":[]},{"given":"Isaac","family":"Winterburn","sequence":"additional","affiliation":[]},{"given":"Michael P","family":"Kelly","sequence":"additional","affiliation":[]},{"given":"Robert","family":"Brodrick","sequence":"additional","affiliation":[]},{"given":"Kristian","family":"Pollock","sequence":"additional","affiliation":[]},{"given":"Megha","family":"Majumder","sequence":"additional","affiliation":[]},{"given":"Anna","family":"Spathis","sequence":"additional","affiliation":[]},{"given":"Iain","family":"Lawrie","sequence":"additional","affiliation":[]},{"given":"Rob","family":"George","sequence":"additional","affiliation":[]},{"given":"Richella","family":"Ryan","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4505-7743","authenticated-orcid":false,"given":"Stephen","family":"Barclay","sequence":"additional","affiliation":[]}],"member":"239","published-online":{"date-parts":[[2020,6,16]]},"reference":[{"key":"2024051711095651000_10.3.343.1","unstructured":"National Institute for Health and Care Excellence . 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