Adjustment of pharmacotherapy during the final days of life in home hospice care: a pilot retrospective study

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00179906%3A_____%2F25%3A10499052" target="_blank" >RIV/00179906:_____/25:10499052 - isvavai.cz</a>

Výsledek na webu

<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=nMOcXWkmK" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=nMOcXWkmK</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.21037/apm-24-146" target="_blank" >10.21037/apm-24-146</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Adjustment of pharmacotherapy during the final days of life in home hospice care: a pilot retrospective study

Popis výsledku v původním jazyce

Background: Effective end-of-life care requires transitioning pharmacotherapy from chronic disease management to symptom relief. Patients in pre-terminal and terminal palliative care may be at risk of receiving potentially inappropriate drugs regarding indication, dosage, route of administration, and polypharmacy, which can increase the risk of deteriorating quality of life. However, data on this process in Home Hospice Care (HHC) is limited. This pilot retrospective study evaluated the pharmacotherapy of 50 patients during their final days under HHC, focusing on changes in treatment and preferred administration routes to optimize symptomatic care. Methods: Anonymised medical records data were analysed retrospectively to assess the shift from chronic disease pharmacotherapy to symptom and quality-of-life-focused treatment. Statistical methods were applied to identify trends in drug utilisation and administration routes. Results: The study group qualified the most common drugs associated with potential drug-related problems: antidepressants (26%), sedatives/hypnotics (32%), gastroprotection (34%), antihypertensives (46%), coanalgesics (50%), and analgesics (84%). On the final day, the mean was 2.64 systemic medication (standard deviation 1.27), with a minimum number of drugs and a maximum of 6. The most common symptom addressed was pain, which occurred in 28 patients in the group (56%). Therefore, terminal analgosedation was mapped in more detail when, at the end of life, 26 patients (52%) were terminally transferred to continuous medication administered subcutaneously. Continuous subcutaneous linear driver for analgosedation containing two components was used in 12 patients (46.2%) or three components in 14 patients (53.8%). Conclusions: This retrospective study highlights the importance of targeted pharmacotherapy adjustments in terminal care, including multidisciplinary HHC teams. Pharmacotherapy is simplified and targeted to prevalent symptoms, using the widely used subcutaneous drug administration.

Název v anglickém jazyce

Adjustment of pharmacotherapy during the final days of life in home hospice care: a pilot retrospective study

Popis výsledku anglicky

Background: Effective end-of-life care requires transitioning pharmacotherapy from chronic disease management to symptom relief. Patients in pre-terminal and terminal palliative care may be at risk of receiving potentially inappropriate drugs regarding indication, dosage, route of administration, and polypharmacy, which can increase the risk of deteriorating quality of life. However, data on this process in Home Hospice Care (HHC) is limited. This pilot retrospective study evaluated the pharmacotherapy of 50 patients during their final days under HHC, focusing on changes in treatment and preferred administration routes to optimize symptomatic care. Methods: Anonymised medical records data were analysed retrospectively to assess the shift from chronic disease pharmacotherapy to symptom and quality-of-life-focused treatment. Statistical methods were applied to identify trends in drug utilisation and administration routes. Results: The study group qualified the most common drugs associated with potential drug-related problems: antidepressants (26%), sedatives/hypnotics (32%), gastroprotection (34%), antihypertensives (46%), coanalgesics (50%), and analgesics (84%). On the final day, the mean was 2.64 systemic medication (standard deviation 1.27), with a minimum number of drugs and a maximum of 6. The most common symptom addressed was pain, which occurred in 28 patients in the group (56%). Therefore, terminal analgosedation was mapped in more detail when, at the end of life, 26 patients (52%) were terminally transferred to continuous medication administered subcutaneously. Continuous subcutaneous linear driver for analgosedation containing two components was used in 12 patients (46.2%) or three components in 14 patients (53.8%). Conclusions: This retrospective study highlights the importance of targeted pharmacotherapy adjustments in terminal care, including multidisciplinary HHC teams. Pharmacotherapy is simplified and targeted to prevalent symptoms, using the widely used subcutaneous drug administration.

Druh

J_ost - Ostatní články v recenzovaných periodicích

CEP obor

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OECD FORD obor

30104 - Pharmacology and pharmacy

Projekt

<a href="/cs/project/NU20-09-00045" target="_blank" >NU20-09-00045: Analýza faktorů ovlivňujících kvalitu života u nemocných v paliativní onkologické péči - personalizovaný přístup v specializované ambulanci.</a><br>

Návaznosti

P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)

Rok uplatnění

2025

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Annals of Palliative Medicine

ISSN

2224-5820

e-ISSN

2224-5839

Svazek periodika

14

Číslo periodika v rámci svazku

2

Stát vydavatele periodika

CN - Čínská lidová republika

Počet stran výsledku

10

Strana od-do

136-145

Kód UT WoS článku

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EID výsledku v databázi Scopus

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