Potentially Inappropriate Prescriptions in End-of-Life Cancer Patients in Home-Based Hospice Care.

Area of Science:

• Oncology
• Palliative Care
• Pharmacology

Background:

• Polypharmacy and inappropriate prescribing are significant issues in end-of-life cancer care, impacting symptom management and quality of life.
• Data on potentially inappropriate medications (PIMs) and prescribing omissions (PPOs) of opioids are limited in South Korea, especially in home-based hospice settings.

Purpose of the Study:

• To evaluate the prevalence of PIMs and PPOs in advanced cancer patients receiving home-based hospice care.
• To identify factors associated with PIMs and PPOs in this patient population.

Main Methods:

• A retrospective observational study of 102 advanced cancer patients referred to home-based hospice care.
• PIMs assessed using STOPPFrail criteria; PPOs defined as inadequate opioid prescribing for moderate to severe pain.
• Logistic regression analysis used to identify associated factors.

Main Results:

• PIMs were present in 40.2% of patients, more common in those over 70 and with comorbidities.
• Statins and antihypertensives were the most frequent PIMs.
• 45.5% of patients with moderate to severe pain experienced PPOs; older age and comorbidities were associated with PIMs, while diabetes was linked to PPOs.

Conclusions:

• Significant gaps exist in medication management for end-of-life cancer patients.
• Systematic deprescribing and strategies to address opioid prescribing hesitancy are crucial.
• Improved medication management can better align treatments with end-of-life goals and enhance patient quality of life.