Prescription patterns for older patients approaching the end of life.
Research type
Research Study
Full title
Prescriptions patterns for older patients approaching the end of life in the hospice and hospital palliative care setting.
IRAS ID
167865
Contact name
Carmel Hughes
Contact email
Duration of Study in the UK
0 years, 11 months, 31 days
Research summary
The optimal use of medications in patients approaching the end of life, especially in those dying from non-cancer conditions remains mostly unexplored, despite recognition that treatment goals should be redefined in the setting of reduced life expectancies. Medication use can have negative consequences for older patients approaching the end of life in relation to high pill burdens, painful injections, risk of side effects, drug interactions and medication errors. In end of life care the goals of treatment should be shifted towards ensuring the patient’s comfort therefore medications should focus on treating symptoms, ensuring that the patient is comfortable and avoiding the associated risks and burdens of medication use.
Drugs are not routinely withdrawn and prescriptions not routinely modified to reflect changes in the course of advanced illnesses. While considerable attention has been given to ensuring appropriate symptom management as death approaches, little is known about the medications prescribed for patients being cared for in the hospice or hospital palliative care setting. Previous research has suggested that cognitive impairment is common as death approaches and can influence the quality of care the patient receives. Describing prescription patterns in patients with and without cognitive impairment approaching the end of life is important as these conditions may be risk factors for over and underuse of medication as well as for non-compliance and adverse drug reactions.
This study therefore aims to examine medication use during the last seven days of life, in deceased older patients who were cared for in selected hospices and hospital palliative care units throughout Northern Ireland. In doing so, we will seek to identify if any differences exist between the prevalence and nature of medication use during the last seven days of life by older patients with cognitive impairment compared to those with no cognitive impairment.
REC name
HSC REC B
REC reference
15/NI/0002
Date of REC Opinion
22 Jan 2015
REC opinion
Favourable Opinion