Cancer Res Treat.  2013 Sep;45(3):220-225.

Evaluation of Prescribing Medications for Terminal Cancer Patients near Death: Essential or Futile

  • 1Department of Internal Medicine, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
  • 2Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea.


The purpose of this study is to evaluate the prescription of essential or futile medications for terminal cancer patients during their final admission.
We conducted a retrospective review of the medical charts of terminally ill cancer patients admitted to the Hemato-oncology Department of two teaching hospitals from March 1, 2007 to December 31, 2009. Essential medications were based on the drugs listed by the International Association for Hospice and Palliative Care, while futile medications were defined when short-term benefit to patients with respect to survival, quality of life, or symptom control was not anticipated.
A total of 196 patients were included. Among essential medications, strong opioids were the most frequently prescribed drugs during the last admission (62.2% fentanyl, 44.3% morphine), followed by megestrol (46.0%), and metoclopramide (37.2%); 51% of gastric protectors were prescribed with potential futility. Anti-hypertensive and antiglycemic agents were administered to those who experienced arterial blood pressure below 90 mm Hg (47.3%) or presented with a single measurement of fasting glucose below 50 mg/dL (10.7%), respectively. Statins were prescribed to 6.1% (12/196) of patients, and 75% of those prescriptions were regarded as futile.
Our data suggest that effective prescription of essential medications and withdrawal from futile medications should be actively reconciled for improvement of a patient's end-of-life care.


Drug therapy; Medical futility; Neoplasms; Symptom

MeSH Terms

Analgesics, Opioid
Arterial Pressure
Hospitals, Teaching
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Medical Futility
Palliative Care
Quality of Life
Retrospective Studies
Terminally Ill
Analgesics, Opioid


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