Continuous subcutaneous infusions (CSCIs) are widely employed in the United Kingdom to deliver medications for symptom management when oral administration is not feasible. Currently, CSCIs are generally administered over a 24-hour period, based on available safety data. Extending CSCI administration to 48 hours could offer potential advantages for patient care and healthcare resource utilization. This service evaluation aimed to determine how frequently CSCI prescriptions are modified in NHS acute hospital settings. Pharmacists and palliative care team members at seven acute NHS hospitals collected anonymized prescription information for CSCIs containing two or more drugs. Data recorded daily included drug combinations, dosages, diluents, and compatibility, with a minimum observation period of 2 days and a maximum of 7 days. Across the seven hospitals, 1301 prescriptions from 288 patients were recorded, representing 584 unique drug combinations. Of these, 91% (n = 533) contained an opioid. The ten most frequently prescribed drug combinations accounted for 37% of all combinations. The median duration for which a CSCI prescription remained unchanged at all sites was 2 days. The findings indicate that administering medications via CSCI over 48 hours could be feasible. Prior to conducting a clinical feasibility study, further work is required, including pharmacoeconomic evaluation, detailed chemical and microbiological stability testing, and exploration of the acceptability of 48-hour infusions among clinical staff, patients, and families.
