BACKGROUND The management of medicines towards the end of life can place increasing burdens and responsibilities on patients and families. This has received little attention yet it can be a source of great difficulty and distress patients and families. Dose administration aids can be useful for some patients but there is no evidence for their wide spread use or the implications for their use as patients become increasing unwell. The study aimed to explore how healthcare professionals describe the support they provide for patients to manage medications at home at end of life. METHODS Qualitative interview study with thematic analysis. Participants were a purposive sample of 40 community healthcare professionals (including GPs, pharmacists, and specialist palliative care and community nurses) from across two English counties. RESULTS Healthcare professionals reported a variety of ways in which they tried to support patients to take medications as prescribed. While the paper presents some solutions and strategies reported by professional respondents it was clear from both professional and patient/family caregiver accounts in the wider study that rather few professionals provided this kind of support. Standard solutions offered included: rationalising the number of medications; providing different formulations; explaining what medications were for and how best to take them. Dose administration aids were also regularly provided, and while useful for some, they posed a number of practical difficulties for palliative care. More challenging circumstances such as substance misuse and memory loss required more innovative strategies such as supporting ways to record medication taking; balancing restricted access to controlled drugs and appropriate pain management and supporting patient choice in medication use. CONCLUSIONS The burdens and responsibilities of managing medicines at home for patients approaching the end of life has not been widely recognised or understood. This paper considers some of the strategies reported by professionals in the study, and points to the great potential for a more widely proactive stance in supporting patients and family carers to understand and take their medicines effectively. By adopting tailored, and sometimes, 'outside the box' thinking professionals can identify immediate, simple solutions to the problems patients and families experience with managing medicines.

中文翻译：

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探索专业人士在家庭药品管理中支持接近寿命终止的患者的经验。定性研究。

背景技术在生命快要结束时进行药物管理会给患者和家庭带来越来越大的负担和责任。这很少引起注意，但可能会给患者和家庭带来极大的困难和困扰。剂量给药辅助剂对某些患者可能有用，但没有证据表明它们的广泛使用或随着患者病愈增加其使用意义。该研究旨在探讨医疗保健专业人员如何描述他们为患者提供生命周期内在家管理药物的支持。方法采用主题分析进行定性访谈研究。参与者来自两个英国县的40位社区医疗保健专业人员（包括全科医生，药剂师，专职姑息治疗和社区护士）。结果医护人员报告了他们尝试以多种方式支持患者按处方服药。尽管本文提出了一些由专业受访者报告的解决方案和策略，但从更广泛的研究中的专业人士和患者/家庭护理人员的账户中可以清楚地看到，很少有专业人士提供这种支持。提供的标准解决方案包括：使药物数量合理化；提供不同的表述；说明使用什么药物以及如何最好地服用它们。还定期提供剂量管理辅助工具，尽管对某些人有用，但它们为姑息治疗带来了许多实际困难。诸如药物滥用和记忆丧失之类的更具挑战性的情况要求采取更具创新性的策略，例如支持记录用药情况的方法；平衡受管制药物的使用限制和适当的疼痛管理，并支持患者选择药物治疗。结论临终患者的在家管理药物的负担和责任尚未得到广泛认可或理解。本文考虑了专业人士在研究中报告的一些策略，并指出了在支持患者和家庭护理人员有效地理解和服用药物方面采取更广泛主动态度的巨大潜力。通过采用量身定制的（有时是“开箱即用的”）思维，专业人员可以识别出即时，