Related Experiment Videos
Prescribing Patterns of End-of-Life Medication for Compassionate Discharge: A Retrospective Observational Cohort
Yu Qing Elysia Ong1, Poh Heng Chong2, Xu Yi Ling1
1KK Women's and Children's Hospital, Singapore, Singapore.
Journal of Palliative Care
|July 29, 2026
Summary
Anticipatory prescribing for patients on home hospice care in Singapore is common, with opioids, antisecretory drugs, and sedatives frequently used. The number of medication classes increased significantly from discharge to death.
Area of Science:
- Palliative Care
- Pharmacology
- Geriatric Medicine
Background:
- Home is a preferred place of death in Singapore, necessitating effective symptom management through anticipatory prescribing for compassionate discharge.
- Lack of standardized guidelines for anticipatory prescribing in home hospice settings leads to unclear medication patterns.
Purpose of the Study:
- To investigate medication use in adult patients on terminal care at home in Singapore.
- To evaluate the types and dosages of drugs prescribed during compassionate discharge and end-of-life care.
Main Methods:
- Retrospective observational cohort study of 129 home hospice patients compassionately discharged.
- Review of all prescribed medications, extracting names and dosages, categorized by pharmacological action.
- Analysis of medication classes prescribed at discharge versus time of death.
Main Results:
- A median of one medication was prescribed per patient; cancer patients required more medications.
- Opioids, antisecretory drugs, and sedatives were the most prescribed classes (89.9%, 86.8%, 86.0%).
- The median number of anticipatory medication classes increased from 2 at discharge to 4 by death (P < .001).
Conclusions:
- Cancer patients had a higher drug burden, warranting further investigation into confounders.
- Anticipatory prescribing practices at the end of life can be refined to reduce potential drug wastage.
- Standardized guidelines are needed to optimize medication use in home hospice care.
Related Concept Videos
01:15Drug Dosing: Geriatric Patients
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
01:31Discharge Summary Forms
The discharge summary is crucial as it enables a smooth transition from a healthcare facility to a patient's home or another care setting. This critical document facilitates seamless continuity of care, ensuring patients receive the necessary support and attention.
Here's a detailed look at the key components and guidelines for preparing a discharge summary:
Here's a detailed look at the key components and guidelines for preparing a discharge summary:
01:27Pharmacodynamics in Geriatric Patients: Effects of Age
Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
01:30Ethical Dilemmas II
Resolving an ethical dilemma in healthcare involves a systematic approach that considers every aspect of the issue, respecting both the patient's needs and values and the healthcare professional's ethical obligations. Here are potential steps to resolve an ethical dilemma:
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
01:27Nursing Ethical Principles II
Ethical principles are essential in guiding nurses to fulfill their responsibilities, focusing on the quality of nursing care and decision-making. These principles, including autonomy, beneficence, non-maleficence, justice, and fidelity, shape the ethical framework within healthcare settings.
Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
Initially, Mr. John's cancer...
Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
Initially, Mr. John's cancer...