Emergency Medication Kits in Home Palliative Care

: The majority of patients with in-home palliative care desire to remain at home through their end of life. However, symptomatic crises, unless promptly controlled, can cause unwanted hospital admissions. In the past 2 decades, it has become common to place a package of several medications in the patient's home for family caregivers to use to treat symptoms when the oral route is lost. These emergency medication kits(EMK)are capable of addressing the common symptoms that arise at end of life, such as pain, dyspnea, delirium, and retained respiratory secretions. The EMK are for the patient or family caregivers to use at the direction of their home hospice nurse or physician. Medications in the EMK are selected for their versatility in potentially addressing multiple symptoms, and their ability to be administered buccally, sublingually, or transdermally, simplifying administration by family caregivers. The EMK facilitate timely symptom control, allowing families to avoid emergency department visits, unscheduled nursing visits, and usually result in cost savings. Additionally, family caregivers feel empowered by its presence in their home and its contribution to patient, family caregiver and nurse satisfaction. To date in Japan, the literature related to the use and impact of EMKs is sparse. Further investigation is needed into the use, clinical efficacy, and impact of the EMK.