CARiAD
Research type
Research Study
Full title
CARer-ADministration of as-needed subcutaneous medication for breakthrough symptoms in homebased dying patients: a UK study.
IRAS ID
227970
Contact name
Clare Wilkinson
Contact email
Sponsor organisation
Bangor University
ISRCTN Number
ISRCTN11211024
Duration of Study in the UK
0 years, 11 months, 30 days
Research summary
People who are seriously ill and nearing the end of their life may want to be cared for in their own homes. As their illness worsens they may find it difficult to take medications by mouth. In the UK, when this happens, it is usual practice for a cannula to be put in – this is a small plastic tube placed under the skin. Once it is in place it can be used to give the person medication under the skin without using needles – this is sometimes called a subcutaneous injection. If a person is on regular medications, a syringe pump is often connected to the cannula to give these medications throughout the day and night to keep symptoms controlled. The person may experience some symptoms even when this is in place – these are called ‘breakthrough’ symptoms and the most common are pain, agitation, nausea and noisy breathing (rattle). When this happens, a friend/family member is advised to call a healthcare professional (HCP), usually a district nurse. The nurse will visit and give the patient an extra dose of medication using the cannula that is already in place. It can take a long time, often much more than an hour, for the nurse to arrive, prepare and give the medication. This wait can be distressing for patient and carer.
In some parts of the world such as Australia, carers are trained and educated by the district nurses to recognise breakthrough symptoms, and prepare and give these extra doses by “no-needle” subcutaneous injection. It is not known whether this approach would be welcomed in the UK. The aim of the CARiAD project is to adapt a successful Australian carer training package for a UK context and test its feasibility and acceptability to patients, carers and healthcare professionals.
REC name
Wales REC 1
REC reference
17/WA/0208
Date of REC Opinion
3 Aug 2017
REC opinion
Further Information Favourable Opinion