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Unlicensed uses for medication in a palliative care unit.

C V Atkinson, S R Kirkham

    Palliative Medicine
    |September 4, 1999
    PubMed
    Summary

    Doctors frequently prescribe medications for unapproved uses in palliative care. This practice, often supported by research, helps manage difficult-to-control symptoms in patients with advanced malignancy.

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    Area of Science:

    • Palliative Care Medicine
    • Pharmacology
    • Oncology

    Background:

    • Palliative care units manage patients with advanced malignancy, often requiring complex symptom management.
    • Established drug licenses may not cover all indications needed for optimal patient care.

    Purpose of the Study:

    • To assess the frequency and scope of medication use for unlicensed indications within a specialist palliative care unit.
    • To compare prescribed medications against licensed indications for patients with advanced malignancy.

    Main Methods:

    • A prospective study was conducted over four months in a 10-bed specialist palliative care unit.
    • Prescriptions for all admitted patients with advanced malignancy were reviewed.
    • Prescribing events were compared with official licensed prescribing indications.

    Main Results:

    • Seventy-six patients were included, with 689 prescriptions issued for 84 different drugs across 34 symptoms.
    • Fifteen percent of all prescribing events were for indications not supported by product licenses.
    • Unlicensed drug use was common, particularly for managing challenging symptoms.

    Conclusions:

    • Medications are frequently utilized for unlicensed purposes in palliative care settings.
    • This off-label prescribing, while often literature-supported, is crucial for symptom control in advanced malignancy.
    • Further research may be warranted to explore the efficacy and safety of these unlicensed uses.

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