Research Roundup

This month's roundup will present some of the latest independent prescribing research in palliative care prescribing. This is a complex speciality where patients frequently have multiple comorbidities, and opioid prescribing is common. To establish the most recent literature in the area, a search of CINAHL and MEDLINE databases was conducted, which yielded five publications (Bowers and Redsell, 2017; Hall, Thompson, Phair, and Davies, 2019; Latham and Nyatanga, 2018a, 2018b; Ziegler, Bennett, Mulvey, Hamilton and Blenkinsopp, 2018).

In this study, routinely collected data were analysed to investigate the growth in nurse and pharmacist prescribing from April 2011 to April 2015 in England. During the study period, non-medical prescribers (NMP) were responsible for around 6.7% of prescriptions issued in community palliative care. Comparisons were made between medical and non-medical prescribers and an overall growth of 32% was reported in prescriptions over the study period, with an annual 28% increase in drugs prescribed by NMP. Analysis of the types of drug prescribed by NMP revealed an increase in opioid prescribing of around 30% each year and smaller increases in nonopioid prescribing of between 10 and 32%. Opioid prescribing by medical prescribers remained unchanged. This suggests that changes to the misuse of drugs act in 2012, permitting more liberal opioid prescribing (HMSO, 2015), have had a direct impact on end-of-life care, which may have improved the quality of care provided to this population.