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- Title
ANTICIPATORY PRESCRIBING IN COMMUNITY PALLIATIVE AND END-OF-LIFE CARE: A REALIST REVIEW.
- Authors
McChesney, Ruth; McClunie-Trust, Patricia
- Abstract
Background: Access to community palliative and end-of-life care that is patientcentred, culturally sensitive and responsive is not equitable for all people in New Zealand. There is an opportunity to transform primary palliative care through an anticipatory prescribing approach and an interdisciplinary workforce. Research is needed to inform the development of best practice and give confidence to authorised prescribers. Aim: This study aimed to identify the factors influencing anticipatory prescribing in community palliative and end-of-life care. Methodology: A literature search was undertaken of the databases CINAHL Complete, Science Direct, PubMed, Google Scholar, Grey Lit, Open Grey, Mednar and Open Core. Seven relevant primary research studies were selected. A meta-synthesis of the qualitative research was carried out using a critical realist framework. Findings: Three main themes emerged from the reviewed articles to explain the factors influencing anticipatory prescribing in community palliative and end-of-life care, including expertise, teamwork and prioritisation. Expertise had two subthemes, which were knowing when to prescribe and knowing how to prescribe. Conclusions: Developing and maintaining expertise in primary palliative care, developing better interdisciplinary teamwork, and the prioritising of this prescribing practice are the factors underpinning effective anticipatory prescribing in palliative and end-of-life care. There is an ethical responsibility to anticipate the likely deterioration and end-of-life needs of palliative patients, so timely care can be provided and symptoms managed. Anticipatory prescribing should be individualised, approached with an equity lens, and delivered through an interdisciplinary health workforce to effectively meet population needs.
- Subjects
CINAHL database; ONLINE information services; META-synthesis; TEAMS in the workplace; TERMINAL care; SYSTEMATIC reviews; PREVENTIVE health services; DRUGS; MEDLINE; THEMATIC analysis; PALLIATIVE treatment; COMMUNITY health nursing
- Publication
Kaitiaki Nursing Research, 2021, Vol 12, Issue 1, p32
- ISSN
1179-772X
- Publication type
Article