Journal Article

Appropriate use of medication among home care adult cancer patients at end of life: a retrospective observational study

Dabbous, Ala’a, Salmany, Sewar S., Ayyalawwad, Haya, Aljarrat, Batool, Mughrabi, Amani El

2024

Overview

Background Medications are commonly used for symptom control in cancer patients at the end of life. This study aimed to evaluate medication utilization among home care palliative patients with cancer at the end of life and assess the appropriateness of these medications. Method This retrospective observational study included adult cancer patients who received home care in 2020. Medications taken during the last month of the patient’s life were reviewed and classified into three major categories: potentially avoidable, defined as medications that usually have no place at the end of life because the time to benefit is shorter than life expectancy; medications of uncertain appropriateness, defined as medications that need case-by-case evaluation because they could have a role at the end of life; and potentially appropriate, defined as medications that provide symptomatic relief. Results In our study, we enrolled 353 patients, and 2707 medications were analyzed for appropriateness. Among those, 1712 (63.2%) were classified as potentially appropriate, 755 (27.9%) as potentially avoidable, and 240 (8.9%) as medications with uncertain appropriateness. The most common potentially avoidable medications were medications for peptic ulcers and gastroesophageal reflux disease (30.5%), vitamins (14.6%), beta-blockers (9.8%), anticoagulants (7.9%), oral antidiabetics (5.4%) and insulin products (5.3%). Among the potentially appropriate medications, opioid analgesics were the most frequently utilized medications (19.5%), followed by laxatives (19%), nonopioid analgesics (14.4%), gamma-aminobutyric acid analog analgesics (7.7%) and systemic corticosteroids (6%). Conclusion In home care cancer patients, approximately one-third of prescribed medications were considered potentially avoidable. Future measures to optimize medication use in this patient population are essential.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adult / Age / Aged / Aged, 80 and over / Analgesics / Anticoagulants (Medicine) / Avoidable medications / Cancer / Cancer patients / Care and treatment / Chronic illnesses / Disease / Dosage and administration / Drug therapy / Evidence-based medicine / Female / GABA / Gastroesophageal reflux / Gender / Health aspects / Home care / Home Care Services - standards / Home Care Services - statistics & numerical data / Home health care / Hospice care / Humans / Hypoglycemic agents / Jordan / Life expectancy / Male / Medical care / Medicine / Medicine & Public Health / Middle Aged / Multivariate analysis / Neoplasms - complications / Neoplasms - drug therapy / Observational studies / Oncology, Experimental / Opioids / Pain Medicine / Palliative / Palliative care / Palliative Medicine / Patients / Peptic ulcer / Quality of life / Quality of Life Research / Retrospective Studies / Symptom management / Symptomatic / Terminal Care - methods / Terminal Care - standards / Terminal Care - statistics & numerical data / Utilization