Publication details
Hospice vs. Hospital: Is There a Difference in Pharmacotherapy of Dying Cancer Patient?
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| Year of publication | 2011 |
| Type | Conference abstract |
| Citation | |
| Description | Research aims: It is extended view among palliative care specialist that pharmacotherapy in dying cancer patients in oncological hospitals does not often reflect their specific needs. Patients are supposed to be at risk of over- or undertreatment. With the aim to verify this view we have performed the comparison of pharmacotherapy delivered within last day of life. Study design and methods: Data were collected on a random sample of patients who died for terminal cancer (i.e. non-sudden, expected death) in cancer center (N=54; mean age 59,9±,7) and hospices (N=03; 70,8±,7). Results: There was a statistically significant difference between cancer center and hospice in particular drug use. The significant difference was found in the use of: antibiotics (hospice 0,97% vs. cancer center 7,8%), anticoagulants (hospice,5% vs. cancer center 4,6%), PPI (hospice 6,% vs. cancer center 64,8%), laxatives (hospice 35,9% vs. cancer center 7,4%), psychotropic drugs - antidepressant, anxiolytics, antipsychotics (hospice 7,8% vs. cancer center 38,8%), total dose of opioids analgesics (hospices: median 50 mg vs. cancer center median 90 mg; p< 0,00). Significant difference was also found in the rate of parenteral hydration (hospice 39,8% vs. cancer center 83,3%). Conclusion: There is a difference between hospice and academic cancer center in drug use in the last 4 hours of patient s life. Higher proportion of use of antidepressants and anxiolytics as well as higher mean doses of opioid analgesics and lower artificial hydration rate in hospices may be the indicators of appropriate comfort-oriented care of dying patients. The results of our study partly support the palliative care specialist view that pharmacotherapy of dying patients in acute care cancer center often does not reflect specific context and goals of end of life care. The possible consequences and interpretations of results will be discussed. |