Just-in-case drugs in the dying: home deaths retrospective chart review

To evaluate whether the Isle of Wight (IoW) Just-in-Case (JIC) scheme to supply and administer anticipatory medication to end-of-life patients was performing to an appropriate level of performance.

A retrospective chart review was conducted on patients who were considered end of life and who died at home on the IoW during 2022.

JIC medication was prescribed to 88% (n=70/80) of patients. Of these patients, half were administered at least four of the five medicines listed on the IoW JIC scheme. Almost three-quarters (71%, n=50/70) of patients had the standard dosage regimens amended to provide individualised treatment, and 96% (n=67/70) of patients saw some alterations to their ongoing management after initialisation of treatment. The time between prescribing and administration of JIC medication was short.

The JIC scheme on the IoW allowed patients to receive timely and individualised care. One or more JIC drugs were administered to a higher proportion of patients than in previous studies; further work is required to establish why (eg, the use of a 24/7 home visiting palliative care nursing team in this locality) and whether this led to improved family confidence that symptoms were effectively controlled.