Anticipatory prescribing for end of life care in the community: a survey of community nurses in England

Anticipatory prescribing is increasingly common in the UK, yet little is known about nurses’ roles in the process. As part of a wider study, a postal survey of 575 community or district, nursing home and palliative care nurses was undertaken in two regions. Responses appeared to show anticipatory prescribing as a common practice and, once in place, prescriptions were often used. Nurses reported taking prominent roles throughout the anticipatory prescribing process and principal responsibility for administering and monitoring medications. Many respondents recounted good working relationships with GPs. However, some reported issues including being challenged by GPs who were reluctant to prescribe medication, being given incorrect prescriptions and having difficulty in gaining access to the necessary medications. Qualitative comments indicated that being a nurse prescriber could enhance confidence to use anticipatory prescriptions. Importantly, respondents perceived that anticipatory prescriptions facilitated provision of good end of life care.