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

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

• Lee HR
• Yi SY
• Kim DY

Abstract

PURPOSE
The purpose of this study is to evaluate the prescription of essential or futile medications for terminal cancer patients during their final admission.
MATERIALS AND METHODS
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.
RESULTS
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.
CONCLUSION
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.

Keyword

Drug therapy; Medical futility; Neoplasms; Symptom

MeSH Terms

Analgesics, Opioid
Arterial Pressure
Fasting
Fentanyl
Glucose
Hospices
Hospitals, Teaching
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Medical Futility
Megestrol
Metoclopramide
Palliative Care
Prescriptions
Quality of Life
Retrospective Studies
Terminally Ill
Analgesics, Opioid
Fentanyl
Glucose
Megestrol
Metoclopramide

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