Changes in prescribing for terminal care patients in general practice, hospital and hospice over a five-year period

Differences in prescribing between 1981 and 1986 were examined for 100 terminal care patients admitted to a city hospice in each year. Prescribing before and after the patients were admitted to the hospice was also compared for the two years. Between 1981 and 1986 there was a large increase in the number of patients receiving morphine sulphate tablets and a reduction in the numbers receiving Brompton's mixture and other unsuitable analgesics both before and after admission. Contrary to critical opinion, general practitioners showed more acceptable prescribing patterns in both years than hospital doctors. In the hospice more patients received non-narcotic analgesics and parenteral diamorphine by syringe driver in 1986 than in 1981. The need for an organized system of postgraduate training in terminal care is considered.