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Just-in-case medication use by ambulance paramedics responding to end-of-life care in the community: protocol for a multi-method study (RELIEF)

Chris Moore, Mark Kingston Orcid Logo, Idris Baker, Natasha Campling, Marika Hills, Emyr Jones, Sian Jones, Rashmi Kumar, Edward O’Brian, Alison Porter Orcid Logo, Berni Sewell, Lauren Williams, Cendl Xanthe

British Paramedic Journal, Volume: 10, Issue: 3, Pages: 1 - 9

Swansea University Authors: Mark Kingston Orcid Logo, Alison Porter Orcid Logo, Berni Sewell

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DOI (Published version): 10.29045/14784726.2025.12.10.3.1

Abstract

Introduction: At the end of life, anticipatory or just-in-case (JIC) medications may help manage patients’ symptoms. Sometimes, emergency ambulances attend patients for whom JIC medications have not been prescribed. In Wales, UK, a Welsh Ambulance Services University NHS Trust (WAST) JIC interventio...

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Published in: British Paramedic Journal
ISSN: 1478-4726
Published: Class Publishing 2025
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URI: https://cronfa.swan.ac.uk/Record/cronfa71380
first_indexed 2026-02-03T16:01:43Z
last_indexed 2026-03-04T05:32:36Z
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spelling 2026-03-03T10:30:30.9468987 v2 71380 2026-02-03 Just-in-case medication use by ambulance paramedics responding to end-of-life care in the community: protocol for a multi-method study (RELIEF) 3442763d6ff0467963e0792d2b5404fa 0000-0003-2242-4210 Mark Kingston Mark Kingston true false fcc861ec479a79f7fb9befb13192238b 0000-0002-3408-7007 Alison Porter Alison Porter true false f6a4af2cfa4275d2a8ebba292fa14421 Berni Sewell Berni Sewell true false 2026-02-03 MEDS Introduction: At the end of life, anticipatory or just-in-case (JIC) medications may help manage patients’ symptoms. Sometimes, emergency ambulances attend patients for whom JIC medications have not been prescribed. In Wales, UK, a Welsh Ambulance Services University NHS Trust (WAST) JIC intervention was launched in May 2020 in response to COVID-19, to enable ambulance paramedics to administer JIC medications to patients for whom they had not previously been prescribed. The ambulance JIC intervention is an ongoing feature of WAST pre-hospital care but has received limited evaluation. This study will explore the rationale, usage, costs and views of stakeholders of the WAST JIC medications intervention.Methods: We will employ a multi-method observational study design that incorporates both quantitative and qualitative aspects, informed by implementation science. We will prepare a detailed description of the WAST JIC medications intervention, its rationale and its use. We will interview paramedics and doctors who have provided the intervention, as well as paid and informal carers who were present during the care episode. We will also hold a focus group with paramedics who have not administered the intervention and undertake a cost analysis to estimate costs and savings associated with the intervention. We will use descriptive statistics to analyse quantitative data and a framework approach for qualitative data.Conclusion: This study, which focuses on the voices of patient advocates and practitioners, has the potential to shape future provision of this and similar services in WAST and other care providers. Journal Article British Paramedic Journal 10 3 1 9 Class Publishing 1478-4726 emergency medical services; end-of-life care; palliative care; pre-hospital care; primary health care 1 12 2025 2025-12-01 10.29045/14784726.2025.12.10.3.1 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Other This work is supported by a grant from the Health and Care Research Wales Research for Patient and Public Benefit programme (RfPPB) (reference: 1913). 2026-03-03T10:30:30.9468987 2026-02-03T12:43:09.1665471 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Chris Moore 1 Mark Kingston 0000-0003-2242-4210 2 Idris Baker 3 Natasha Campling 4 Marika Hills 5 Emyr Jones 6 Sian Jones 7 Rashmi Kumar 8 Edward O’Brian 9 Alison Porter 0000-0002-3408-7007 10 Berni Sewell 11 Lauren Williams 12 Cendl Xanthe 13 71380__36340__e1353d2b14b14f8e805c0c85ae0fa883.pdf 71380.VoR.pdf 2026-03-03T10:27:10.9812015 Output 296000 application/pdf Version of Record true © The Author(s) 2025. This article is Open Access under the terms of the Creative Commons (CC BY) licence. true eng https://creativecommons.org/licenses/by/2.0/
title Just-in-case medication use by ambulance paramedics responding to end-of-life care in the community: protocol for a multi-method study (RELIEF)
spellingShingle Just-in-case medication use by ambulance paramedics responding to end-of-life care in the community: protocol for a multi-method study (RELIEF)
Mark Kingston
Alison Porter
Berni Sewell
title_short Just-in-case medication use by ambulance paramedics responding to end-of-life care in the community: protocol for a multi-method study (RELIEF)
title_full Just-in-case medication use by ambulance paramedics responding to end-of-life care in the community: protocol for a multi-method study (RELIEF)
title_fullStr Just-in-case medication use by ambulance paramedics responding to end-of-life care in the community: protocol for a multi-method study (RELIEF)
title_full_unstemmed Just-in-case medication use by ambulance paramedics responding to end-of-life care in the community: protocol for a multi-method study (RELIEF)
title_sort Just-in-case medication use by ambulance paramedics responding to end-of-life care in the community: protocol for a multi-method study (RELIEF)
author_id_str_mv 3442763d6ff0467963e0792d2b5404fa
fcc861ec479a79f7fb9befb13192238b
f6a4af2cfa4275d2a8ebba292fa14421
author_id_fullname_str_mv 3442763d6ff0467963e0792d2b5404fa_***_Mark Kingston
fcc861ec479a79f7fb9befb13192238b_***_Alison Porter
f6a4af2cfa4275d2a8ebba292fa14421_***_Berni Sewell
author Mark Kingston
Alison Porter
Berni Sewell
author2 Chris Moore
Mark Kingston
Idris Baker
Natasha Campling
Marika Hills
Emyr Jones
Sian Jones
Rashmi Kumar
Edward O’Brian
Alison Porter
Berni Sewell
Lauren Williams
Cendl Xanthe
format Journal article
container_title British Paramedic Journal
container_volume 10
container_issue 3
container_start_page 1
publishDate 2025
institution Swansea University
issn 1478-4726
doi_str_mv 10.29045/14784726.2025.12.10.3.1
publisher Class Publishing
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
document_store_str 1
active_str 0
description Introduction: At the end of life, anticipatory or just-in-case (JIC) medications may help manage patients’ symptoms. Sometimes, emergency ambulances attend patients for whom JIC medications have not been prescribed. In Wales, UK, a Welsh Ambulance Services University NHS Trust (WAST) JIC intervention was launched in May 2020 in response to COVID-19, to enable ambulance paramedics to administer JIC medications to patients for whom they had not previously been prescribed. The ambulance JIC intervention is an ongoing feature of WAST pre-hospital care but has received limited evaluation. This study will explore the rationale, usage, costs and views of stakeholders of the WAST JIC medications intervention.Methods: We will employ a multi-method observational study design that incorporates both quantitative and qualitative aspects, informed by implementation science. We will prepare a detailed description of the WAST JIC medications intervention, its rationale and its use. We will interview paramedics and doctors who have provided the intervention, as well as paid and informal carers who were present during the care episode. We will also hold a focus group with paramedics who have not administered the intervention and undertake a cost analysis to estimate costs and savings associated with the intervention. We will use descriptive statistics to analyse quantitative data and a framework approach for qualitative data.Conclusion: This study, which focuses on the voices of patient advocates and practitioners, has the potential to shape future provision of this and similar services in WAST and other care providers.
published_date 2025-12-01T05:32:36Z
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