Prescription Trends in Hospice Care: A Longitudinal Retrospective and Descriptive Medication Analysis.

Wernli, Ursina; Hischier, Désirée; Meier, Christoph R; Jean-Petit-Matile, Sibylle; Panchaud, Alice; Kobleder, Andrea; Meyer-Massetti, Carla (2023). Prescription Trends in Hospice Care: A Longitudinal Retrospective and Descriptive Medication Analysis. American journal of hospice and palliative care, 40(8), pp. 820-828. Sage 10.1177/10499091221130758

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BACKGROUND

In hospice and palliative care, drug therapy is essential for symptom control. However, drug regimens are complex and prone to drug-related problems. Drug regimens must be simplified to improve quality of life and reduce risks associated with drug-related problems, particularly at end-of-life. To support clinical guidance towards a safe and effective drug therapy in hospice care, it is important to understand prescription trends.

OBJECTIVES

To explore prescription trends and describe changes to drug regimens in inpatient hospice care.

DESIGN

We performed a retrospective longitudinal and descriptive analysis of prescriptions for regular and as-needed (PRN) medication at three timepoints in deceased patients of one Swiss hospice.

SETTING/SUBJECTS

Prescription records of all patients ( 18 years) with an inpatient stay of three days and longer (admission and time of death in 2020) were considered eligible for inclusion.

RESULTS

Prescription records of 58 inpatients (average age 71.7 ± 12.8 [37-95] years) were analyzed. The medication analysis showed that polypharmacy prevalence decreased from 74.1% at admission to 13.8% on the day of death. For regular medication, overall numbers of prescriptions decreased over the patient stay while PRN medication decreased after the first consultation by the attending physician and increased slightly towards death.

CONCLUSIONS

Prescription records at admission revealed high initial rates of polypharmacy that were reduced steadily until time of death. These findings emphasize the importance of deprescribing at end-of-life and suggest pursuing further research on the contribution of clinical guidance towards optimizing drug therapy and deprescribing in inpatient hospice care.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)

Graduate School:

Graduate School for Health Sciences (GHS)

UniBE Contributor:

Wernli, Ursina, Panchaud Monnat, Alice Elke Martine, Meyer-Massetti, Carla Verena

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1938-2715

Publisher:

Sage

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

13 Oct 2022 19:42

Last Modified:

11 Jul 2023 00:11

Publisher DOI:

10.1177/10499091221130758

PubMed ID:

36168963

Uncontrolled Keywords:

deprescribing hospice hospice care medication analysis medication safety polypharmacy

BORIS DOI:

10.48350/173731

URI:

https://boris.unibe.ch/id/eprint/173731

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