Anticipatory syringe drivers: a step too far.

Abstract

The recent Gosport War Memorial Hospital inquiry [1] has increased UK patient, public, and clinician awareness about syringe drivers for continuous subcutaneous delivery of opioids and other medications at the end of life. [2, 3] The inquiry found that at least 456 patients died where opioids had been prescribed and administered in unjusified doses, commonly via syringe drivers. In safe hands, syringe drivers facilitate safe and effective control of pain and other symptoms for patients who are no longer able to swallow or absorb oral medication, commonly when close to the end of life. Gosport highlights the importance of ‘safe hands’. In an overstretched clinical climate in which clinicians are encouraged to plan ahead to optimise patient care, Gosport is a timely warning of the potential dangers of ‘anticipatory syringe drivers’ - prescribed in anticipation of future symptoms at the end of life.