التفاصيل البيبلوغرافية
| العنوان: |
Inappropriate medication use and polypharmacy in end-stage cancer patients: Isn't it the family doctor's role to de-prescribe much earlier? |
| المؤلفون: |
Garfinkel, Doron, Ilin, Nataly, Waller, Alexander, Torkan‐Zilberstein, Ashley, Zilberstein, Netanel, Gueta, Itai, Torkan-Zilberstein, Ashley |
| المصدر: |
International Journal of Clinical Practice; Apr2018, Vol. 72 Issue 4, p1-1, 7p, 1 Diagram, 1 Chart |
| مستخلص: |
Background: Elderly patients are exposed to increased number of medications, often with no proof of a positive benefit/risk ratio. Unfortunately, this trend does not spare those with limited life expectancy, including end-stage cancer patients who require only palliative treatment. For many medications in this subpopulation, the risk of adverse drug events outweighs the possible benefits and yet, many are still poly-medicated during their last year of life.Aim: To describe the extent of polypharmacy among end-stage cancer patients, at the time of admission to homecare hospice.Methods: A retrospective chart review of 202 patients admitted to Homecare Hospice of the Israel Cancer Association and died before January 2015.Results: Average lifespan from admission until death was 39.2 ± 5.4 days. 63% died within the first month, 89% within 3 months. Excluding oncological treatments, 181 (90%) and 46 (23%) patients were treated with ≥ 6 and ≥ 12 drugs for chronic diseases, respectively. Two months before death, 32 (16%) patients were treated with ≥ 3 blood pressure lowering drugs, 62 (31%) with statins and 48 (23%) with aspirin.Conclusion: Though not representative of the whole end-stage cancer patient population, our study demonstrates that these patients are exposed to extensive polypharmacy. Most of these medications could have probably been safely de-prescribed much earlier in the course of the malignant disease. Considering the prolonged trust-based relationship with their patients, the family physicians are those who should be encouraged to implement the palliative approach and reduce polypharmacy much before reaching hospice settings. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |