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Anticipatory prescribing — DGM MCQ

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HardEnd-of-life careAnticipatory prescribingDGM

An 88-year-old man with metastatic lung cancer is deteriorating at home and wishes to remain there. He has intermittent pain, nausea and noisy respiratory secretions. The district nurse asks how to prepare for likely symptoms. Current medicines include morphine modified-release and laxatives. What is the most appropriate management?

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Correct answer: C — Prescribe individualised anticipatory medicines with clear indications

Anticipatory medicines for pain, nausea, breathlessness, agitation and secretions can support symptom control at home when individualised and documented. Waiting for crisis, hospital transfer solely for prescribing, indiscriminate antibiotics and stopping symptom medicines are poor care. Anticipatory prescribing should include route, dose, indication and review.

Reference: NICE NG31