[Teminal care in a nursing home].

Area of Science:

• Gerontology
• Palliative Care
• Pharmacology

Background:

• Patients with limited life expectancy often reach a stage where preventive medications offer no benefit.
• This critical period, termed End-of-Life (EOL), precedes formal palliative care qualification.
• Current prescribing practices for EOL patients lack comprehensive, evidence-based guidelines.

Purpose of the Study:

• To identify and evaluate international guidelines for medication prescribing in the End-of-Life (EOL) phase.
• To address the gap in knowledge regarding optimal medication management for EOL patients.
• To explore key questions surrounding the identification of EOL patients and appropriate drug discontinuation.

Main Methods:

• Literature review and assessment of international clinical guidelines.
• Analysis of existing recommendations and expert opinions.
• Exploration of logical assumptions and expert thought processes in the absence of clinical trials.

Main Results:

• No relevant clinical trials were identified for EOL prescribing.
• Guidance for EOL prescribing is primarily based on logical assumptions and expert reasoning.
• Optimal prescribing strategies for EOL patients remain largely unexamined.
• Two critical questions emerged: identifying EOL patients and determining which drugs to discontinue.

Conclusions:

• There is a significant need for evidence-based guidelines for medication prescribing in the End-of-Life (EOL) phase.
• Further research is required to establish clear criteria for identifying EOL patients.
• Developing protocols for medication withdrawal in EOL care is essential for improving patient outcomes.