TY - JOUR
T1 - Changes in medication profile among patients with advanced cancer admitted to an acute palliative care unit
AU - Hui, David
AU - Li, Zhijun
AU - Chisholm, Gary B.
AU - Didwaniya, Neha
AU - Bruera, Eduardo
N1 - Funding Information:
This work was supported in part by National Institutes of Health grants R01NR010162-01A1, R01CA122292-01, and R01CA124481-01 (Dr. Bruera). This study is also supported by the MD Anderson Cancer Center Support Grant (CA 016672) and an institutional startup grant no. 18075582 (Dr. Hui).
Publisher Copyright:
© 2014, Springer-Verlag Berlin Heidelberg.
PY - 2015/2
Y1 - 2015/2
N2 - Methods: We included consecutive patients with advanced cancer who were first seen by our inpatient palliative care consultation team and subsequently admitted to the APCU. We retrieved data on all scheduled medications at the prespecified time points.Purpose: The decision-making process for medication use in the last weeks of life is complex because of patient frailty and poor prognosis. Limited literature is available on medication use in the palliative care setting, particularly in acute palliative care units (APCUs). We examined the changes in medication profile among hospitalized patients with advanced cancer before their palliative care inpatient consultation team referral, after palliative care consultation, at the time of APCU admission, and at APCU discharge or death.Results: Among the 100 patients, the median duration of hospitalization was 10.5 days (interquartile range 8–15 days), and the median APCU stay was 5 days (interquartile range 3–7 days). The average number of medications before palliative care inpatient consultation team referral, after palliative care consultation, at APCU admission and at APCU discharge/death was 9.2 (standard deviation [SD] 4.5), 9.9 (SD 4.2), 10.3 (SD 3.8), and 10.1 (SD 3.8), respectively (P = 0.03). An increasing proportion of patients received medications for symptom control over their course of hospitalization, including systemic corticosteroids, laxatives, neuroleptics, and antiulcer agents (P < 0.05). In contrast, the frequency of several classes of medications such as antihypertensives, antilipemics, and anticonvulsants decreased over time (P < 0.05).Conclusions: Palliative care involvement was associated with an increase in symptom control medications and decrease in medications for comorbid conditions over time.
AB - Methods: We included consecutive patients with advanced cancer who were first seen by our inpatient palliative care consultation team and subsequently admitted to the APCU. We retrieved data on all scheduled medications at the prespecified time points.Purpose: The decision-making process for medication use in the last weeks of life is complex because of patient frailty and poor prognosis. Limited literature is available on medication use in the palliative care setting, particularly in acute palliative care units (APCUs). We examined the changes in medication profile among hospitalized patients with advanced cancer before their palliative care inpatient consultation team referral, after palliative care consultation, at the time of APCU admission, and at APCU discharge or death.Results: Among the 100 patients, the median duration of hospitalization was 10.5 days (interquartile range 8–15 days), and the median APCU stay was 5 days (interquartile range 3–7 days). The average number of medications before palliative care inpatient consultation team referral, after palliative care consultation, at APCU admission and at APCU discharge/death was 9.2 (standard deviation [SD] 4.5), 9.9 (SD 4.2), 10.3 (SD 3.8), and 10.1 (SD 3.8), respectively (P = 0.03). An increasing proportion of patients received medications for symptom control over their course of hospitalization, including systemic corticosteroids, laxatives, neuroleptics, and antiulcer agents (P < 0.05). In contrast, the frequency of several classes of medications such as antihypertensives, antilipemics, and anticonvulsants decreased over time (P < 0.05).Conclusions: Palliative care involvement was associated with an increase in symptom control medications and decrease in medications for comorbid conditions over time.
KW - Antihypertensives
KW - Antilipemics
KW - Corticosteroids
KW - Laxatives
KW - Medications
KW - Neoplasms
KW - Neuroleptics
KW - Palliative care
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U2 - 10.1007/s00520-014-2390-1
DO - 10.1007/s00520-014-2390-1
M3 - Article
C2 - 25123192
AN - SCOPUS:84939897816
SN - 0941-4355
VL - 23
SP - 427
EP - 432
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
IS - 2
ER -