Acceptability of supporting lay-carer administration of anticipatory subcutaneous medications at home: a qualitative study using the theoretical framework of acceptability
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Background
Globally, evidence indicates that most people prefer to receive care and die at home, provided high-quality care is available. However, systemic and logistical challenges often prevent this outcome. Palliate is a nurse-led intervention aiming to address these barriers, supporting lay-carers in administering end-of-life subcutaneous medications to their loved ones, through training, written guidance, and documentation.
Aim
To explore the perceptions and experiences of patients, carers, and healthcare professionals regarding the acceptability of the Palliate intervention, using the Theoretical Framework of Acceptability (TFA), including perceived barriers and opportunities to its implementation.
Methods
A qualitative study was conducted using semi-structured interviews with healthcare professionals, patients, carers, and policy-makers, informed by the TFA. Data were analysed thematically using deductive analysis.
Results
Thirty participants, including people with a diagnosis of advanced illness, carers, and a range of healthcare professionals involved in end-of-life care, provided perspectives on the acceptability of the intervention in end-of-life care. Participants described potential benefits, including improved symptom management, reduced waiting times for medication, and increased empowerment for families to support care at home. Concerns were raised about carer burden, emotional responsibility, and the need for professional oversight. Some participants spoke from direct experience of administering or supporting the intervention in practice, providing insights into both its practical value and the challenges of implementation.
Conclusion
While the Palliate intervention was generally viewed as acceptable and potentially beneficial, its broader implementation requires careful consideration. Its acceptability was conditional on carers receiving clear training, ongoing professional support, and being able to participate voluntarily. These findings offer new insights into the boundaries of lay caregiving and have implications for the implementation of family-administered end-of-life care within health systems. Further research is needed to evaluate its safety, impact, and feasibility in diverse contexts before wider adoption can be recommended.
Globally, evidence indicates that most people prefer to receive care and die at home, provided high-quality care is available. However, systemic and logistical challenges often prevent this outcome. Palliate is a nurse-led intervention aiming to address these barriers, supporting lay-carers in administering end-of-life subcutaneous medications to their loved ones, through training, written guidance, and documentation.
Aim
To explore the perceptions and experiences of patients, carers, and healthcare professionals regarding the acceptability of the Palliate intervention, using the Theoretical Framework of Acceptability (TFA), including perceived barriers and opportunities to its implementation.
Methods
A qualitative study was conducted using semi-structured interviews with healthcare professionals, patients, carers, and policy-makers, informed by the TFA. Data were analysed thematically using deductive analysis.
Results
Thirty participants, including people with a diagnosis of advanced illness, carers, and a range of healthcare professionals involved in end-of-life care, provided perspectives on the acceptability of the intervention in end-of-life care. Participants described potential benefits, including improved symptom management, reduced waiting times for medication, and increased empowerment for families to support care at home. Concerns were raised about carer burden, emotional responsibility, and the need for professional oversight. Some participants spoke from direct experience of administering or supporting the intervention in practice, providing insights into both its practical value and the challenges of implementation.
Conclusion
While the Palliate intervention was generally viewed as acceptable and potentially beneficial, its broader implementation requires careful consideration. Its acceptability was conditional on carers receiving clear training, ongoing professional support, and being able to participate voluntarily. These findings offer new insights into the boundaries of lay caregiving and have implications for the implementation of family-administered end-of-life care within health systems. Further research is needed to evaluate its safety, impact, and feasibility in diverse contexts before wider adoption can be recommended.
Date Issued
2025-12-30
Date Acceptance
2025-11-10
Citation
BMC Palliative Care, 2025, 24
ISSN
1472-684X
Publisher
BMC
Journal / Book Title
BMC Palliative Care
Volume
24
Copyright Statement
© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/41286769
PII: 10.1186/s12904-025-01942-9
Subjects
Human centred design
Innovation
Palliative Care
Person centred care
Qualitative Research
Humans
Qualitative Research
Female
Male
Caregivers
Middle Aged
Aged
Home Care Services
Adult
Injections, Subcutaneous
Terminal Care
Interviews as Topic
Aged, 80 and over
Patient Acceptance of Health Care
Palliative Care
Publication Status
Published
Coverage Spatial
England
Article Number
312
Date Publish Online
2025-11-24