61 Medication access and supply issues as a barrier to good symptom management: how big is the problem?. (15th December 2021)

• Record Type: Journal Article
• Authors: Nohavicka, Laura; Patel, Bhumik; Chadwick, Anna; Bluebond-Langner, Myra
• Is Part Of: Archives of disease in childhood. Volume 106(2021)Supplement 3
• Page Start: A23
• Page End: A23
• Publication Date: 2021-12-15
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2021-gosh.61
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Background: The prevalence of children living with life limiting conditions is increasing. Care of these children is complex, requiring care in a number of settings from a number of professionals. Issues arise from: access and supply of medications across settings; confidence in prescribing unlicensed or off label medications; lack of effective communication between individuals and institutions. This can lead to delays in delivery of needed symptom management. Objectives: Identify and quantify access and supply issues for patients receiving specialist palliative care and consider how they might be ameliorated. Methods: All instances of medication access and supply issues for patients referred to the palliative care team between February 2020-August 2020 were recorded. Access and supply issues were coded by type, location, and patient consequences. Results: 102 patients were referred to the tertiary palliative care team over the study period. 58 patients have symptom management plans. 14 patients (24% 14/58) patients had documented difficulties with medication access and supply. These issues occurred across all service providers. Common issues identified were: Lack of ability to source drugs locally Difficulty or inability to prescribe medications in the community Incorrect preparations dispensed Delay in prescribing medications Issues with ongoing supply for non-formulary medications Resolving these issues took a significant portion of the palliative care team's time. Two patients required emergency readmission to hospital for symptoms which could have been managed effectively at home. Conclusions: 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.