Chun-Li Wang1, Chia-Yen Lin2,3,4, Chun-Che Huang5, Chu-Sheng Lin1,6, Chung-Chieh Hu1,7, Sheau-Feng Hwang8,9, Ting-Ting Yen9,10,11, Yi-Sheng Liou1, Lung-Chun Lee12,13. 1. Department of Family Medicine, Taichung Veterans General Hospital, No.1650, Sec. 4, Taiwan Blvd., Xitun Dist., Taichung City, 407, Taiwan, Republic of China. 2. Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan. 3. Division of Surgical Critical Care, Department of Critical Care Medicine, Taichung Veterans General Hospital, Taichung, Taiwan. 4. Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan. 5. Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan. 6. Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan. 7. Division of Palliative Medicine, Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan. 8. Department of Obstetrics, Gynecology & Women's Health, Taichung Veterans General Hospital, Taichung, Taiwan. 9. Palliative Care Unit, Taichung Veterans General Hospital, Taichung, Taiwan. 10. Department of Otolaryngology, Taichung Veterans General Hospital, Taichung, Taiwan. 11. School of Medicine, National Yang-Ming University, Taipei, Taiwan. 12. Department of Family Medicine, Taichung Veterans General Hospital, No.1650, Sec. 4, Taiwan Blvd., Xitun Dist., Taichung City, 407, Taiwan, Republic of China. cw1601zx@vghtc.gov.tw. 13. Division of Palliative Medicine, Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan. cw1601zx@vghtc.gov.tw.
Abstract
PURPOSE: The purpose of this study is to determine the possible correlation between the do-not-resuscitate (DNR) status and the prescribed use of systemic strong opioid analgesics (SSOA) among patients with terminal cancer in Taiwan. METHODS: This retrospective cross-sectional study used data from a single tertiary care medical center. We identified patients with terminal cancer who died after signing a DNR order between 2008 and 2016. Subsequently, we reviewed their clinical characteristics, DNR consent type, survival time after DNR declaration, and SSOA dose. RESULTS: Of the 4123 patients enrolled for this study, 1380 (33.5%) had received SSOA before DNR and 2742 (66.5%) had received SSOA after DNR (p < 0.001). SSOA doses administered after the DNR order were significantly higher than those administered before the DNR order (median, 78 vs. 60 mg, p < 0.01). CONCLUSION: Patients' DNR status likely influenced physician decision in prescribing SSOA. However, additional studies are necessary to clarify the factors that influence the decision-making of physicians regarding SSOA prescription.
PURPOSE: The purpose of this study is to determine the possible correlation between the do-not-resuscitate (DNR) status and the prescribed use of systemic strong opioid analgesics (SSOA) among patients with terminal cancer in Taiwan. METHODS: This retrospective cross-sectional study used data from a single tertiary care medical center. We identified patients with terminal cancer who died after signing a DNR order between 2008 and 2016. Subsequently, we reviewed their clinical characteristics, DNR consent type, survival time after DNR declaration, and SSOA dose. RESULTS: Of the 4123 patients enrolled for this study, 1380 (33.5%) had received SSOA before DNR and 2742 (66.5%) had received SSOA after DNR (p < 0.001). SSOA doses administered after the DNR order were significantly higher than those administered before the DNR order (median, 78 vs. 60 mg, p < 0.01). CONCLUSION:Patients' DNR status likely influenced physician decision in prescribing SSOA. However, additional studies are necessary to clarify the factors that influence the decision-making of physicians regarding SSOA prescription.
Entities:
Keywords:
Do-not-resuscitate; Pain; Systemic strong opioid analgesics; Terminal cancer
Authors: Emily A Meier; Jarred V Gallegos; Lori P Montross Thomas; Colin A Depp; Scott A Irwin; Dilip V Jeste Journal: Am J Geriatr Psychiatry Date: 2016-01-22 Impact factor: 4.105
Authors: M H J van den Beuken-van Everdingen; J M de Rijke; A G Kessels; H C Schouten; M van Kleef; J Patijn Journal: Ann Oncol Date: 2007-03-12 Impact factor: 32.976
Authors: Marieke H J van den Beuken-van Everdingen; Janneke M de Rijke; Alfons G Kessels; Harry C Schouten; Maarten van Kleef; Jacob Patijn Journal: Pain Date: 2007-10-03 Impact factor: 6.961