Deprescribing in Palliative Cancer Care

Area of Science:

• Palliative Care
• Oncology
• Pharmacology

Background:

• Palliative care aims to maximize quality of life (QoL) during life-threatening illnesses.
• Preventive medications are often deprescribed late in cancer care, despite potential lack of benefit.
• Discontinuing medications requires careful consideration of benefits, side effects, and withdrawal symptoms.

Purpose of the Study:

• To provide evidence-based guidance on deprescribing medications in palliative cancer care.
• To advise on the optimal timing and methods for discontinuing specific drug classes.
• To support clinicians in optimizing medication regimens for end-of-life care.

Main Methods:

• Review of current evidence and clinical practice guidelines.
• Analysis of drug classes commonly used in cancer patients.
• Focus on deprescribing strategies for various medications.

Main Results:

• Specific guidance is offered for deprescribing antihypertensives, statins, anticoagulants, aspirin, anti-diabetics, proton pump inhibitors, H2-blockers, bisphosphonates, denosumab, urologicals, antidepressants, cortisone, thyroxin, and vitamins.
• Distinction made between drugs that can be stopped directly and those requiring slow tapering.
• Emphasis on prioritizing symptom relief and QoL.

Conclusions:

• Timely deprescribing of non-beneficial medications is crucial in palliative cancer care.
• Understanding drug-specific deprescribing protocols can prevent adverse withdrawal effects.
• Optimizing medication management enhances patient quality of life during advanced illness.