The End of Life & Palliative Care template can be accessed from the 'person and coat' iconunder the patient name and address.
During the COVID-19 pandemic, clinicians may encounter a crisis situation where either a health care professional is unavailable to give EoL injectables or another situation where a syringe driver is unavailable.
Two new pages have therefore been added on to the end of the Ardens 'End of Life Formulary' template to assist prescribing should you find yourself in one of these crisis situations.
If your CCG has it's own localised End of Life Formulary on Ardens and would like these pages added to their formulary, please just let us know by emailing: firstname.lastname@example.org
For instructions on how to use the end of life formulary and pre-populating community drug chart, please see from 2mins 42secs in the video below.
The End of Life Formularies on Ardens are pre-set to a quantity of 3 ampoules for subcutaneous prescriptions. This quantity was chosen after discussions with multiple Medicines Management and Pharmacy Departments on the bases of balancing adequate supply whilst minimising waste.
Why do Ardens choose 3 ampoules?
In the majority of cases, anticipatory drugs are prescribed and are never used resulting in waste which can lead to:
- Shortage of end of life medication when a patient really needs it
- Increased quantities of controlled drugs in the community with risks concerning supervision of use and safe disposal.
- Unnecessary cost and expenses to the NHS
Why do Ardens not just prescribe 5 ampoules?
End of Life drugs often come in a pack of 5. Whilst prescribing in a pack of 5 may be convenient, it often goes to waste and results in the issues above. By prescribing 3 ampoules for anticipatory medicines means that for every 3 packs (15 ampoules) this is sufficient to supply 5 patients with anticipatory medicine, rather than only 3 patients.
When should you prescribe more ampoules?
Whilst in the majority of cases End of Life medicines are prescribed in anticipation, in some cases a patient is sufficiently symptomatic to need immediate subcutaneous end of life treatment. If this is the case, then even 5 ampoules is likely to be insufficient and the patient is likely to need 10 or more ampoules prescribing.
When else should you prescribe more ampoules?
You may also consider increasing the number of ampoules prescribed to cover Out-Of-Hour periods over weekends and bank holidays.
How do I prescribe more ampoules?
If you wish to prescribe more than 3 ampoules, you can use the Ardens End of Life Formulary as normal but after clicking on a medication you can then right click the medication in the view at the bottom of the template and increase the number of ampoules from 3 to the quantity required.
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