Jimmy J Arevalo1, Eric C T Geijteman2,3, Bregje A A Huisman1, Marianne K Dees4, Wouter W A Zuurmond1,5, Lia van Zuylen2, Agnes van der Heide3, Roberto S G M Perez1,5. 1. 1 Department of Anesthesiology, VU University Medical Center , Amsterdam, the Netherlands . 2. 2 Department of Medical Oncology, Erasmus MC Cancer Institute , Rotterdam, the Netherlands . 3. 3 Department of Public Health, Erasmus University Medical Center , Rotterdam, the Netherlands . 4. 4 Scientific Center for Quality of Healthcare (IQ Healthcare), Radboud Institute for Health Sciences, Radboud University Medical Center , Nijmegen, the Netherlands . 5. 5 Hospice Kuria , Amsterdam, the Netherlands .
Abstract
BACKGROUND: The purpose of medication management in the last days of life is to optimize patient's comfort. Little is known about the medication use in the days before death and how this relates to the care setting. OBJECTIVE: To describe medication use in the last week of life for patients dying in hospital, hospice, and home settings in the Netherlands. DESIGN: Retrospective chart review study. SETTING: A convenience sample of patient records from the three settings in three different regions in the Netherlands that cover more than half the country. MEASUREMENTS: Information about medication use in the last week of life of patients who ultimately died an expected death was registered, including type of medication, start and if applicable stop dates, administration routes, and doses. RESULTS: One hundred seventy-nine records were analyzed. Medications most frequently used in the last week of life were analgesics (n = 168, 94.1%) and psycholeptics (n = 150, 84.7%), in particular by hospice patients. The mean number of medications used per patient was nine during day 7 before death and six on the day of dying. On the day of death, 48 (26.8%) patients used a preventive medication. This percentage was highest for patients dying in the hospital or at home. CONCLUSIONS: Patients who die an expected death receive many medications in the last week of life, part of which are preventive medications. Medication management in patients' final days of life can be improved, especially in the hospital and home setting.
BACKGROUND: The purpose of medication management in the last days of life is to optimize patient's comfort. Little is known about the medication use in the days before death and how this relates to the care setting. OBJECTIVE: To describe medication use in the last week of life for patients dying in hospital, hospice, and home settings in the Netherlands. DESIGN: Retrospective chart review study. SETTING: A convenience sample of patient records from the three settings in three different regions in the Netherlands that cover more than half the country. MEASUREMENTS: Information about medication use in the last week of life of patients who ultimately died an expected death was registered, including type of medication, start and if applicable stop dates, administration routes, and doses. RESULTS: One hundred seventy-nine records were analyzed. Medications most frequently used in the last week of life were analgesics (n = 168, 94.1%) and psycholeptics (n = 150, 84.7%), in particular by hospice patients. The mean number of medications used per patient was nine during day 7 before death and six on the day of dying. On the day of death, 48 (26.8%) patients used a preventive medication. This percentage was highest for patients dying in the hospital or at home. CONCLUSIONS:Patients who die an expected death receive many medications in the last week of life, part of which are preventive medications. Medication management in patients' final days of life can be improved, especially in the hospital and home setting.
Authors: Bregje A A Huisman; Eric C T Geijteman; Marianne K Dees; Noralie N Schonewille; Margriet Wieles; Lia van Zuylen; Karolina M Szadek; Agnes van der Heide Journal: BMC Palliat Care Date: 2020-05-13 Impact factor: 3.234
Authors: Kathleen E Bickel; Richard Kennedy; Cari Levy; Kathryn L Burgio; F Amos Bailey Journal: J Gen Intern Med Date: 2019-12-02 Impact factor: 5.128
Authors: Bregje A A Huisman; Eric C T Geijteman; Jimmy J Arevalo; Marianne K Dees; Lia van Zuylen; Karolina M Szadek; Agnes van der Heide; Monique A H Steegers Journal: BMC Palliat Care Date: 2021-07-16 Impact factor: 3.234