Literature DB >> 19030900

Futile medication use in terminally ill cancer patients.

Rachel P Riechelmann1, Monika K Krzyzanowska, Camilla Zimmermann.   

Abstract

BACKGROUND: Cancer patients usually take many medications. The proportion of patients with advanced cancer who are taking futile drugs is unknown.
MATERIALS AND METHODS: We retrospectively reviewed the charts of all consecutive ambulatory patients with advanced cancer and who were receiving supportive care exclusively at palliative care clinics, Princess Margaret Hospital, to gather information on futile medications used by them. Futile medications were defined as unnecessary (when no short-term benefit to patients with respect to survival, quality of life, or symptom control was anticipated) or duplicate (two or more drugs from the same pharmacological class). Summary statistics were used to describe the results.
RESULTS: From November 2005 to July 2006, 82 (22%) of 372 patients were taking at least one futile medication before consultation; after initial consultation, this proportion dropped to 20% (78): 70 patients were taking unnecessary medications, while eight were on duplicate medications. The most frequent unnecessary medications used by patients were statins (56%). The most common duplicate medication involved the use of two different benzodiazepines (seven patients).
CONCLUSION: About one fifth of cancer outpatients at the end of life take futile medications, most commonly statins. Prospective and population-based studies are warranted to further evaluate the magnitude and consequences of futile medication use in oncology.

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Year:  2008        PMID: 19030900     DOI: 10.1007/s00520-008-0541-y

Source DB:  PubMed          Journal:  Support Care Cancer        ISSN: 0941-4355            Impact factor:   3.603


  24 in total

Review 1.  Beyond futility: to what extent is the concept of futility useful in clinical decision-making about CPR?

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Journal:  Lancet Oncol       Date:  2002-10       Impact factor: 41.316

Review 2.  Medical futility and appropriate medical care in patients whose death is thought to be imminent.

Authors:  C P Escalante; C G Martin; L S Elting; E B Rubenstein
Journal:  Support Care Cancer       Date:  1997-07       Impact factor: 3.603

3.  Discontinuing cardiovascular medications at the end of life: lipid-lowering agents.

Authors:  Annette M Vollrath; Christian Sinclair; James Hallenbeck
Journal:  J Palliat Med       Date:  2005-08       Impact factor: 2.947

4.  Medical futility. Who decides?

Authors:  N S Jecker; R A Pearlman
Journal:  Arch Intern Med       Date:  1992-06

Review 5.  Bringing palliative care to a Canadian cancer center: the palliative care program at Princess Margaret Hospital.

Authors:  Camilla Zimmermann; Dori Seccareccia; Allyson Clarke; David Warr; Gary Rodin
Journal:  Support Care Cancer       Date:  2006-06-27       Impact factor: 3.603

Review 6.  Drug-vitamin interaction.

Authors:  T K Basu
Journal:  Int J Vitam Nutr Res Suppl       Date:  1985

7.  The medical futility debate: patient choice, physician obligation, and end-of-life care.

Authors:  Robert A Burt
Journal:  J Palliat Med       Date:  2002-04       Impact factor: 2.947

8.  Use of complementary and alternative medicine by Brazilian oncologists.

Authors:  E S T Samano; L M Ribeiro; A S Campos; F Lewin; E S V Filho; P T Goldenstein; L J M Costa; A del Giglio
Journal:  Eur J Cancer Care (Engl)       Date:  2005-05       Impact factor: 2.520

9.  Praying correlates with higher quality of life: results from a survey on complementary/alternative medicine use among a group of Brazilian cancer patients.

Authors:  Eliana Sueco Tibana Samano; Patricia Taschner Goldenstein; Lia de Melo Ribeiro; Fabio Lewin; Edgar Santiago Valesin Filho; Heloisa Prado Soares; Auro del Giglio
Journal:  Sao Paulo Med J       Date:  2004-07-05       Impact factor: 1.044

10.  Potential drug interactions and duplicate prescriptions among cancer patients.

Authors:  Rachel P Riechelmann; Ian F Tannock; Lisa Wang; Everardo D Saad; Nathan A Taback; Monika K Krzyzanowska
Journal:  J Natl Cancer Inst       Date:  2007-04-18       Impact factor: 13.506

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  36 in total

Review 1.  Drug therapy optimization at the end of life.

Authors:  Alfonso J Cruz-Jentoft; Benoit Boland; Lourdes Rexach
Journal:  Drugs Aging       Date:  2012-06-01       Impact factor: 3.923

2.  Inappropriate prescribing in patients accessing specialist palliative day care services.

Authors:  A Todd; H Nazar; H Pearson; L Andrew; L Baker; A Husband
Journal:  Int J Clin Pharm       Date:  2014-06

3.  Need for Deprescribing in Hospital Elderly Patients Discharged with a Limited Life Expectancy: The REPOSI Study.

Authors:  Luca Pasina; Barbara Brignolo Ottolini; Laura Cortesi; Mauro Tettamanti; Carlotta Franchi; Alessandra Marengoni; Pier Mannuccio Mannucci; Alessandro Nobili
Journal:  Med Princ Pract       Date:  2019-03-20       Impact factor: 1.927

4.  Guiding principles for the care of older adults with multimorbidity: an approach for clinicians: American Geriatrics Society Expert Panel on the Care of Older Adults with Multimorbidity.

Authors: 
Journal:  J Am Geriatr Soc       Date:  2012-09-19       Impact factor: 5.562

5.  Variation in medication use in cancer patients at the end of life: a cross-sectional analysis.

Authors:  N J H Raijmakers; L van Zuylen; C J Furst; M Beccaro; L Maiorana; P Pilastri; C Rossi; G Flego; A van der Heide; M Costantini
Journal:  Support Care Cancer       Date:  2012-10-14       Impact factor: 3.603

6.  Changes in medication profile among patients with advanced cancer admitted to an acute palliative care unit.

Authors:  David Hui; Zhijun Li; Gary B Chisholm; Neha Didwaniya; Eduardo Bruera
Journal:  Support Care Cancer       Date:  2014-08-16       Impact factor: 3.603

7.  Drug interactions in dying patients: a retrospective analysis of hospice inpatients in Germany.

Authors:  Sebastian Frechen; Anna Zoeller; Klaus Ruberg; Raymond Voltz; Jan Gaertner
Journal:  Drug Saf       Date:  2012-09-01       Impact factor: 5.606

8.  Prevalence and factors associated with polypharmacy in older people with cancer.

Authors:  Justin P Turner; Sepehr Shakib; Nimit Singhal; Jonathon Hogan-Doran; Robert Prowse; Sally Johns; J Simon Bell
Journal:  Support Care Cancer       Date:  2014-03-02       Impact factor: 3.603

Review 9.  Discontinuation of Preventive Medicines in Older People with Limited Life Expectancy: A Systematic Review.

Authors:  Sujita W Narayan; Prasad S Nishtala
Journal:  Drugs Aging       Date:  2017-10       Impact factor: 3.923

Review 10.  Supportive Care in Older Adults with Cancer: Across the Continuum.

Authors:  Thuy Koll; Mackenzi Pergolotti; Holly M Holmes; Huibrie C Pieters; G J van Londen; Zachary A Marcum; Amy R MacKenzie; Christopher B Steer
Journal:  Curr Oncol Rep       Date:  2016-08       Impact factor: 5.075

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