Document Detail


Prescribing of pain medication in palliative care. A survey in general practice.
MedLine Citation:
PMID:  18985638     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To examine what pain and adjuvant medication is prescribed in palliative care patients at home in The Netherlands. METHODS: In a nationwide, representative, prospective study in general practice in The Netherlands, prescribed medication was registered in 95 general practices with a listed population of 374 070 patients. The GPs identified those who received palliative care in a retrospective survey of the 2169 patients who died within the 1-year study period. We analysed the analgesics, laxatives and anti-emetics that were prescribed during the last 3 months of life for these patients. RESULTS: The response rate of the survey was 74%. 425 patients received palliative care and 73% of them were prescribed pain medication: 55% a non-opioid analgesic (paracetamol, NSAIDs), 21% a weak opioid (tramadol, codeine), and 51% a strong opioid. Relatively more younger than older patients were prescribed strong opioids, and more cancer than non-cancer patients were prescribed an analgesic. During the last 3 months of life, the proportion of patients prescribed a non-opioid or a weak opioid increased gradually. The proportion of patients prescribed a strong opioid increased considerably nearing the patient's death. About one third of the non-cancer patients were prescribed strong opioids, mostly commencing in the last 2 weeks before death. In 48% of all patients with an opioid prescription, the GP did not prescribe a laxative. CONCLUSIONS: Weak opioids and laxatives are frequently omitted from pain regimens in palliative care at home in The Netherlands.
Authors:
Sander D Borgsteede; Luc Deliens; Wouter W A Zuurmond; François G Schellevis; Dick L Willems; Gerrit Van der Wal; Jacques Th M van Eijk
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pharmacoepidemiology and drug safety     Volume:  18     ISSN:  1099-1557     ISO Abbreviation:  Pharmacoepidemiol Drug Saf     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2009-01-05     Completed Date:  2009-02-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9208369     Medline TA:  Pharmacoepidemiol Drug Saf     Country:  England    
Other Details:
Languages:  eng     Pagination:  16-23     Citation Subset:  IM    
Affiliation:
VU University Medical Center, Department of Public and Occupational Health, EMGO Institute, Amsterdam, The Netherlands. s.borgsteede@vumc.nl
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Aged, 80 and over
Analgesics, Non-Narcotic / therapeutic use*
Analgesics, Opioid / adverse effects,  therapeutic use*
Antiemetics / therapeutic use
Data Collection
Family Practice / methods
Female
Home Care Services / statistics & numerical data
Humans
Laxatives / therapeutic use
Male
Netherlands
Pain / drug therapy*,  etiology
Palliative Care / methods*
Physician's Practice Patterns / statistics & numerical data
Retrospective Studies
Time Factors
Chemical
Reg. No./Substance:
0/Analgesics, Non-Narcotic; 0/Analgesics, Opioid; 0/Antiemetics; 0/Laxatives

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