Analysis of Drugs Prescribed for Terminal Cancer Patients Two Weeks before Death in a Palliative Care Unit

Abstract

Background: Polypharmacy should be minimized in end-of-life care. Therefore, this study aimed to provide a basis for establishing guidelines for drug use in end-of-life care. Methods: This retrospective study involved the medical record review of 45 of the 74 patients who were hospitalized and died at one tertiary hospital palliative care center between January 1 and December 31, 2021. Here comfort care was defined as that provided 14 days prior to death. We analyzed the types and numbers of prescribed drugs used by patients, including palliative care essential drugs and pain control drugs, and examined the prescribed drugs based on their efficacy categorization. Results: According to drug efficacy classification, opioid analgesics, anti-ulcer drugs, and psychoactive drugs were most commonly used. The median number of drugs used was 8.8 (standard deviation, ±3.9) with 86.7% (n=39) of patients belonging to the polypharmacy group using 5 or more drugs. Among the narcotic analgesics used for pain control, morphine (53.3%) and oxycodone (46.7%) were the most frequently used, preferably through the intravenous route. Conclusion:Our study identified the current use of opioid analgesics and other palliative care drugs and confirmed that polypharmacy occurred in the majority of end-of-life care patients. Follow-up studies are needed to establish guidelines for comfort care drug use.

Nurses’ Perception and Performance of End-of-Life Care in a Tertiary Hospital

“…Nurses prioritized the identification of legal forms related to life-sustaining treatment, in line with the Act on Decisions on Life-Sustaining Treatment [ 19 ]. Additionally, it was observed that symptom management for dying patients was actively practiced in this study, with the predominant use of opioids, antiulcer drugs, sedatives, and anxiolytics [ 21 ].…”