Anticipatory Just in Case Medications : Quick guide

Anticipatory, or "Just in case," prescribing is a crucial element in proactive end-of-life (EoL) symptom management. It ensures timely symptom relief during the last days or hours of life, as guided by NICE's 'Care of dying adults in last days of life' (NG31). Prescribing should be considered when a patient is in the final weeks of life, registered as Amber or Red on the Palliative Care Register, receiving home syringe pump treatment, or approved for fast-track Continuing Healthcare (CHC) funding. It also applies to patients with unstable symptoms, variable swallowing ability, or specific medical conditions necessitating alternative medication routes.

Anticipatory prescribing is essential for proactive end-of-life symptom management, particularly for patients in their last days or short weeks (<4 weeks) of life. Key considerations include:

• Discuss with Patient and Relatives: Address common misconceptions.
• History of Drug Misuse: Exercise caution if there's a history of drug misuse by the patient or household members.
• Regular Review: Update prescriptions to reflect clinical changes.
• Transfer Between Settings: Review prescriptions during patient transfers.
• Storage: Store anticipatory medications separately in a box with a lid.

These steps ensure timely and effective symptom control, enhancing patient comfort and care at the...