End of life care in UK care homes - controlled drugs: systematic review and narrative synthesis.

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cam.depositDate2022-06-26
cam.issuedOnline2022-06-29
cam.orpheus.counter29
cam.orpheus.successFri Apr 14 15:07:03 BST 2023 - Embargo updated
dc.contributor.authorMajumder, Megha
dc.contributor.authorBowers, Ben
dc.contributor.authorPollock, Kristian
dc.contributor.authorGoodman, Claire
dc.contributor.authorKuhn, Isla
dc.contributor.authorBarclay, Stephen
dc.contributor.orcidMajumder, Megha [0000-0003-4853-4178]
dc.contributor.orcidBowers, Ben [0000-0001-6772-2620]
dc.contributor.orcidBarclay, Stephen [0000-0002-4505-7743]
dc.date.accessioned2022-06-27T23:31:03Z
dc.date.available2022-06-27T23:31:03Z
dc.date.issued2022-06-29
dc.date.updated2022-06-26T20:47:03Z
dc.description.abstractBACKGROUND: Controlled drugs (CDs) such as opioids and midazolam are commonly used in end-of-life care symptom management for care home residents. AIM: To review the published evidence concerning the prescribing, storage, use and disposal of CDs for end-of-life care for care home residents in the UK. DESIGN: Systematic review and narrative synthesis. METHODS: Seven databases (Medline, CINAHL, Embase, PsycINFO, Web of Science, Cochrane Library, and Social Care Online) were searched from January 2000 to January 2021, alongside reference, citation and journal hand searches. Gough's 'Weight of Evidence' framework was used to appraise the relevance of studies to the review questions. RESULTS: The search yielded 1279 titles, from which 125 abstracts and then 42 full-text papers were screened. 14 papers were included in the synthesis. Prescribing is primarily by general practitioners, with administration by nurses. Nurses frequently report feeling inadequately trained in the use of CDs. The storage, monitoring and disposal of end-of-life care CDs in UK care homes has not been researched to date. The attitudes and experiences of residents and family members regarding these medications also remain unknown. CONCLUSION: The current widespread use of CDs for end-of-life care in care homes has a limited evidence base. The lack of research concerning the storing, monitoring and disposing of CDs, alongside the limited evidence concerning resident and family members' perspectives, is a significant knowledge deficit that requires urgent attention. PROSPERO REGISTRATION NUMBER: CRD42020173014.
dc.description.sponsorshipAbbeyfield Foundation National Institute for Health and Social Care Research
dc.identifier.doi10.17863/CAM.85798
dc.identifier.eissn2045-4368
dc.identifier.issn2045-435X
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/338386
dc.publisherBMJ
dc.publisher.departmentDepartment of Public Health And Primary Care, The Primary Care Unit
dc.publisher.urlhttp://dx.doi.org/10.1136/spcare-2021-003470
dc.rightsAll Rights Reserved
dc.rights.urihttp://www.rioxx.net/licenses/all-rights-reserved
dc.subjectclinical decisions
dc.subjectnursing home care
dc.subjectpain
dc.subjectpharmacology
dc.subjectsymptoms and symptom management
dc.subjectterminal care
dc.titleEnd of life care in UK care homes - controlled drugs: systematic review and narrative synthesis.
dc.typeArticle
dcterms.dateAccepted2022-06-15
prism.publicationNameBMJ Support Palliat Care
pubs.funder-project-idAbbeyfield Research Foundation (grant 23)
pubs.licence-display-nameApollo Repository Deposit Licence Agreement
pubs.licence-identifierapollo-deposit-licence-2-1
rioxxterms.typeJournal Article/Review
rioxxterms.versionAM
rioxxterms.versionofrecord10.1136/spcare-2021-003470
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