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Photo taken on a trip to the Norweigian fjords
I was awarded the title of Queen’s Nurse in 2009 in recognition of my commitment to patient-centered care and interprofessional team working. My desire to help move forward evidence-based community practice led me to my PhD studies, with the goal of becoming a clinical academic in primary care research."  
- Ben Bowers

Ben Bowers has recently joined the SPCR as doctoral trainee (based in Primary Care Unit, University of Cambridge) and has published a paper from a  previous CLAHRC funded sytematic review. He spent 13 years as a Community Nurse, with a specialist interest in palliative care. We spoke to Ben about how his CLAHRC funded results formed the basis of his School application and how he hopes to inform clinical practice.

What are the key findings from your CLAHRC fellowship?

I systematically explored the evidence-base into end-of-life anticipatory prescribing of injectable medications, during my CLAHRC Fellowship, to understand how effective and acceptable this practice is to all involved.

Our systematic review revealed that this widespread practice is based on an insufficient evidence-base. Practice is based largely on the belief of healthcare professionals, that anticipatory prescribing reassures patients and their family carers, effectively controls symptoms and prevents hospital admissions. The views and experiences of patients and their family carers have not been adequately investigated; neither has the clinical-effectiveness, cost-effectiveness or safety of anticipatory prescribing.

I’m confident that the findings from my SPCR PhD will help us better understand current practice, including variances within this, and improve patient-centred end-of-life care."

Which of these findings influenced your SPCR application?

I was motivated by key questions which remained unanswered by our systematic review and resonated with my experiences as a community nurse. I was particularly interested in researching when drugs are issued and if they were subsequently used. There was a clear need to understand the views of patients and their family carers in regard to anticipatory prescribing. These knowledge gaps felt like a distinct and significant PhD project around which to shape my SPCR application.

Why is it an important area of primary care research?

Anticipatory Prescribing is endorsed in national and local guidance as best practice in end-of-life care. However, practice and policy are running ahead of the evidence-base. We need to better understand what happens in practice and explore how patients and their family carers view anticipatory prescribing. 

Do you hope your work will influence primary care practice?

I’m confident that the findings from my SPCR doctoral research will help us better understand current practice, including variances within this, and improve patient-centred end-of-life care.

Did you apply for any other scholarships?

I also applied for a charitable research foundation PhD scholarship. I was fortunate enough to be awarded both scholarships and needed to choose between them: I had not envisaged being in this enviable situation.

Why did you decide to accept the SPCR award?

I chose the SPCR award as it offered unparalleled opportunities to develop my research skills, network with like-minded interdisciplinary peers working in primary care, and be part of a vibrant and supportive NIHR school.


Ben can be contacted at:          Twitter: @Ben_Bowers__

Cambridge Palliative and End of Life Care Group, University of Cambridge

Read the systematic review: Anticipatory prescribing of injectable medications for adults at the end of life in the community: A systematic literature review and narrative synthesis.