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Polypharmacy in palliative care: can it be reduced?

N Y Koh1, W H Koo

  • 1Department of General Medicine, Tan Tock Seng Hospital, Singapore. kohnienyue@yahoo.com.sg

Singapore Medical Journal
|October 17, 2002
PubMed
Summary

Minimizing polypharmacy in palliative care is challenging. While analgesic use remained stable, laxative prescriptions significantly increased post-referral, indicating a focus on managing constipation in palliative patients.

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Area of Science:

  • Palliative Care Medicine
  • Pharmacology
  • Geriatric Medicine

Background:

  • Minimizing polypharmacy is a critical aspect of patient care.
  • Palliative care patients often present complex medication management needs.
  • This study investigates medication use patterns before and after palliative care referral.

Purpose of the Study:

  • To assess the feasibility of reducing polypharmacy in palliative care.
  • To compare drug utilization in patients before and after palliative care referral.
  • To identify common drug classes used in palliative care.

Main Methods:

  • Retrospective review of medication charts for 345 patients.
  • Data collected from hospital-based palliative consultation services, home care, and hospice.
  • Medications were recorded pre-referral and two weeks post-referral or pre-discharge.

Main Results:

  • Median drug use remained five medications per patient, pre and post-referral.
  • Analgesics (60.3%) and laxatives (60%) were frequently prescribed.
  • Laxative use significantly increased post-referral (p<0.01), with 45.3% of patients receiving new laxative prescriptions.

Conclusions:

  • Reducing polypharmacy in palliative care settings is difficult.
  • Increased awareness and treatment of constipation were observed post-referral.
  • Strategies beyond medication review, such as patient education, may help minimize polypharmacy.

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