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Medication chart review at end of life of paediatric palliative patients

Jie Er Janice Soo1, Mei Yoke Chan2, Noor Aisah Bee Bte Adb Rashid2

  • 1Ministry of Health Holdings, Singapore, Singapore.

Journal of Paediatrics and Child Health
|September 23, 2021
PubMed

Insights

Paediatric palliative care (PPC) patients nearing end-of-life received a median of 11.5 medications, with prevalent use of analgesics and antibiotics. Education on managing side effects, like prescribing laxatives with opioids, is recommended.

Area of Science:

  • Palliative Care Medicine
  • Pediatric Pharmacology
  • Clinical Pharmacy

Background:

  • Paediatric palliative care (PPC) focuses on symptom management and quality of life for children with life-limiting illnesses.
  • Understanding medication use in the final weeks of life is crucial for optimizing care and patient comfort.

Purpose of the Study:

  • To review and analyze the types and frequency of medications administered to paediatric palliative care patients in the last two weeks of life.
  • To identify patterns of medication use and areas for potential improvement in PPC.

Main Methods:

  • Retrospective observational cohort study of 42 patients from a single PPC service (2011-2015).
  • Analysis of medication charts for patients within two weeks of death.
  • Data extraction focused on medication categories, diagnoses, and usage frequency.

Main Results:

  • The median number of medications per patient was 11.5.
  • Analgesics (95%) and antibiotics (86%) were the most frequently prescribed medication classes.
  • Opioids were common analgesics (81%), with other frequently used medications including sedatives (52%) and laxatives (48%).

Conclusions:

  • A high volume of medications is utilized in PPC during the final two weeks of life.
  • While analgesia is prevalent, the significant use of antibiotics warrants attention.
  • Recommendations include enhanced education on managing opioid-induced constipation through proactive laxative prescription.
Abstract

Keywords:
inpatientmedicationpaediatric palliative

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