ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2013
Variation in medication use in cancer patients at the end of life: a cross-sectional analysis.
Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 53 citations in OpenAlex.
- Concepts and definitions for "actively dying," "end of life," "terminally ill," "terminal care," and "transition of care": a systematic review.Journal of pain and symptom management · 2014Pooled it
- Polypharmacy, chemotherapy receipt, and medication-related out-of-pocket costs at end of life among commercially insured adults with advanced cancer.Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners · 2022Article
- Medical Cannabis and Utilization of Nonhospice Palliative Care Services: Complements and Alternatives at End of Life.Innovation in aging · 2022Article
- Prescribing practices, patterns, and potential harms in patients receiving palliative care: A systematic scoping review.Exploratory research in clinical and social pharmacy · 2021Article
- Polypharmacy as a prognostic factor in older patients with advanced non-small-cell lung cancer treated with anti-PD-1/PD-L1 antibody-based immunotherapy.Journal of cancer research and clinical oncology · 2020Article
- Older Medicare Beneficiaries Frequently Continue Medications with Limited Benefit Following Hospice Admission.Journal of general internal medicine · 2019Article
- Nurses' Perspectives on Family Caregiver Medication Management Support and Deprescribing.Journal of hospice and palliative nursing : JHPN : the official journal of the Hospice and Palliative Nurses Association · 2019Article
- Clinicians' perceptions of medication errors with opioids in cancer and palliative care services: a priority setting report.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2018Article
- Adequate, questionable, and inadequate drug prescribing for older adults at the end of life: a European expert consensus.European journal of clinical pharmacology · 2018Article
- The characteristics of patients who discontinue their dying process - an observational study at a single university hospital centre.BMC palliative care · 2015Observational
- Variation in physician recommendations, knowledge and perceived roles regarding provision of end-of-life care.BMC palliative care · 2015Article
- Medication use during end-of-life care in a palliative care centre.International journal of clinical pharmacy · 2015Article
- Changes in medication profile among patients with advanced cancer admitted to an acute palliative care unit.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2015Article
- Symptoms and medication management in the end of life phase of high-grade glioma patients.Journal of neuro-oncology · 2014Article
- A comparison of drugs and procedures of care in the Italian hospice and hospital settings: the final three days of life for cancer patients.BMC health services research · 2014Article
- Epilepsy in the end of life phase of brain tumor patients: a systematic review.Neuro-oncology practice · 2014Review
- Commonly prescribed medications in a population of hospice patients.The American journal of hospice & palliative care · 2014Article
- Managing cancer pain at the end of life with multiple strong opioids: a population-based retrospective cohort study in primary care.PloS one · 2014Article
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeDespite advances in cancer treatment, patients still die with unnecessary suffering. Therefore, high-quality end-of-life care is needed. Variations in medication use at the end of life may suggest areas for improvement. This study aims to describe the use of medications during the last days of life of cancer patients and to explore the possibility of using it as a quality measure.
methodsWe conducted an international survey on experts' opinions regarding potentially inappropriate medications for dying patients. Subsequently, a chart review of deceased cancer patients was conducted, which assessed the current medication use in different settings.
resultsThe mean number of medications used in the last 3 days of life was 4.8 (SD 2.1). Hospital patients were less likely than hospice patients to receive opioids, midazolam, haloperidol, and drugs for pulmonary secretions or nausea/vomiting. Over 90 % of experts rated 12 medications as unlikely to be appropriate. Hospital patients were more likely than hospice patients to receive these potentially inappropriate medications. Before the implementation of an end-of-life care pathway, hospital patients had a higher probability, than after, to receive potentially inappropriate medication. Moreover, after implementation of such pathway, patients for whom a pathway was not used were more likely to receive potentially inappropriate medications than patients for whom it was used.
conclusionMedication use at the end of life varies widely by setting, both for potentially appropriate and inappropriate medications. Combining experts' opinion and current medication use resulted in the identification of 16 medications that might be used to assess the quality of cancer care at the end of life.
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