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• W3201830744 abstract "<h3>Background</h3> The number of children living with life limiting conditions (LLC) has increased over the last 17 years with a current prevalence in the UK of 66.1 per 10000. Care of these children is complex, requiring care in a number of settings including district and tertiary hospitals, hospices, communities and family homes from a number of professionals – specialist doctors, general practitioners, nurses, pharmacists as well as parents and carers. Differences in access and supply of medications across settings, as well as differences in confidence in prescribing unlicensed or off label medications, not to mention lack of effective communication between individuals and institutions, can lead to delays in delivery of needed symptom management. <h3>Objectives</h3> To identify and quantify access and supply issues for patients receiving care from a specialist palliative care team at a tertiary centre and to consider the impact of these issues on patients, their families and professionals, as well as ways in which problems could be ameliorated. <h3>Methods</h3> Identification and review of all instances of medication access and supply issues for patients referred to a tertiary palliative care team between February 2020-August 2020 (inclusive) through chart review, reporting and discussion at the weekly multidisciplinary team (MDT) meetings, daily on call handovers and via telephone requests to the team. Access and supply issues were coded by type (e.g. availability, prescribing, dispensing), location (e.g. community, local hospital, tertiary hospital and national) and patient consequences (e.g. change in location of care, delay in receipt of medication). <h3>Results</h3> 102 patients were referred to the tertiary palliative care team over the study period. 87 symptom management plans (SMPs) were written for 58 patients. 14 patients (24% 14/58) patients had documented difficulties with medication access and supply. This issues occurred across all service providers, but were most common in the community and local hospitals. Common issues identified were: Lack of ability to source drugs locally (e.g. ketamine, gabapentin, lansoprazole, diamorphine, aprepitant) Difficulty or inability to prescribe medications in the community Incorrect preparations dispensed Delay in prescribing medications for symptom management Issues with ongoing supply for non-formulary medications Resolving these issues took a significant portion of palliative care team members time. More significantly, however was the impact on patients. Notably two patients required emergency readmission to hospital for symptoms which could have been managed effectively at home had there not been access and supply issues. <h3>Conclusions</h3> Medication access and supply issues affect a significant number of children with LLC and can impact effective symptom control and place of care. Next steps to address these issues include: education program for professionals involved in care of children with LLC focused on medications commonly used in paediatric palliative care, need for timely/anticipatory prescribing and effective collaborative working amongst professionals in a variety of settings where these children are cared for." @default.
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• W3201830744 date "2021-09-30" @default.
• W3201830744 modified "2023-09-25" @default.
• W3201830744 title "1454 Medication access and supply issues as a barrier to good symptom management: how big is the problem?" @default.
• W3201830744 doi "https://doi.org/10.1136/archdischild-2021-rcpch.654" @default.
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