Feasibility and acceptability of carer administered subcutaneous medications in the last days of life: qualitative findings from the CARiAD study.

Hendry, Annie, Poolman, Marlise, Roberts, Jessica Louise, Wilkinson, Clare, Hiscock, Julia and Nelson, Annmarie ORCID: https://orcid.org/0000-0002-6075-8425 2020. Feasibility and acceptability of carer administered subcutaneous medications in the last days of life: qualitative findings from the CARiAD study. Presented at: 11th EAPC World Research Congress, Online, 7-9 October 2020. Abstracts from the 11th EAPC World Research Congress Online. Palliative Medicine. SAGE Publications, 10.1177/2F0269216320958098

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Abstract

Background/aims: The majority of seriously ill people express a wish to die at home. This often depends on the support of a willing and able lay carer. Healthcare professionals (HCPs) visit the home to give medication for breakthrough symptoms. Waiting times may be long, leading to increased symptom duration and patient and carer distress. A randomised controlled open pilot trial sought to assess feasibility and acceptability of training lay carers to give subcutaneous (SC) medications to home-based dying patients for breakthrough symptoms. This paper presents findings from the embedded qualitative study. Methods: In-depth interviews with carers and HCPs. Carer transcripts were analysed using Interpretive Phenomenological Analysis and HCP interviews using Framework analysis. Results: Carers found a sense of purpose in the ability to give SC medications and were comforted by being able to relieve symptoms quickly especially in rural areas and out of hours. Carers concerns regarding potential to cause harm or hasten death were relieved by trial information and training which led to carer confidence in giving medications. The knowledge that their loved ones wish of a home death, as symptom free as possible, was fulfilled, gave comfort to carers post bereavement.HCPs prioritised the wellbeing of their patients above all and echoed the positive responses of the carers but also expressed concerns regarding time needed to train carers, heavy workloads, and staff shortages. They also emphasised careful selection of participants to ensure that there would be no risk of harm to patients, medication misuse or over burdening of carers. Careful selection also provides protection for HCPs who have concerns about accountability. Conclusions: There is disparity between the acceptability and feasibility of implementing the intervention. Overall acceptability of the intervention was overwhelmingly high among carers. In practice, feasibility relies on the ability of the UK NHS and the confidence of staff to deliver care in this way.

Item Type:	Conference or Workshop Item (Poster)
Status:	Published
Schools:	Medicine Marie Curie Palliative Care Research Centre (MCPCRC)
Publisher:	SAGE Publications
ISSN:	0269-2163
Last Modified:	04 Aug 2023 14:30
URI:	https://orca.cardiff.ac.uk/id/eprint/160653

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