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What's in a name?

02 April 2021
Volume 26 · Issue 4

Anticipatory prescribing (AP) of injectable medications to manage common symptoms experienced at the end of life (EoL) is recommended practice (National Institute for Health and Care Excellence (NICE), 2015). AP was initially developed to fix healthcare workflow difficulties and enable ready access to medications, especially during out-of-hours periods. It is now a widespread key intervention in managing dying at home (Bowers et al, 2020).

The language clinicians use to describe AP influences patients' and families' understanding of the nature, significance and purpose of injectable medications and when they are to be used. Surprisingly, at least 22 terms are used in the UK, including ‘just in case medications’, ‘anticipatory medications’, ‘EoL medications’, ‘gold/grey box’, ‘notfallplan’, ‘pre-emptives’, and ‘standby’.

Even the commonly used ‘just in case medications’ can be interpreted in many ways: in case of what? Should they be given to prevent the person from developing pain? Although the presence of anticipatory medications may be reassuring, it may also raise concerns about the dying experience.

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