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Borgsteede, Sander D.; Deliens, Luc; Zuurmond, Wouter W. A.; Schellevis, François G.; Willems, Dick L.; Van der Wal, Gerrit; van Eijk, Jacques Th. M.

Prescribing of pain medication in palliative care. A survey in general practice

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  • Medientyp: E-Artikel
  • Titel: Prescribing of pain medication in palliative care. A survey in general practice
  • Beteiligte: Borgsteede, Sander D.; Deliens, Luc; Zuurmond, Wouter W. A.; Schellevis, François G.; Willems, Dick L.; Van der Wal, Gerrit; van Eijk, Jacques Th. M.
  • Erschienen: Wiley, 2009
  • Erschienen in: Pharmacoepidemiology and Drug Safety
  • Sprache: Englisch
  • DOI: 10.1002/pds.1678
  • ISSN: 1053-8569; 1099-1557
  • Schlagwörter: Pharmacology (medical) ; Epidemiology
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:title>Abstract</jats:title><jats:sec><jats:title>Purpose</jats:title><jats:p>To examine what pain and adjuvant medication is prescribed in palliative care patients at home in The Netherlands.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>In a nationwide, representative, prospective study in general practice in The Netherlands, prescribed medication was registered in 95 general practices with a listed population of 374 070 patients. The GPs identified those who received palliative care in a retrospective survey of the 2169 patients who died within the 1‐year study period. We analysed the analgesics, laxatives and anti‐emetics that were prescribed during the last 3 months of life for these patients.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The response rate of the survey was 74%. 425 patients received palliative care and 73% of them were prescribed pain medication: 55% a non‐opioid analgesic (paracetamol, NSAIDs), 21% a weak opioid (tramadol, codeine), and 51% a strong opioid. Relatively more younger than older patients were prescribed strong opioids, and more cancer than non‐cancer patients were prescribed an analgesic. During the last 3 months of life, the proportion of patients prescribed a non‐opioid or a weak opioid increased gradually. The proportion of patients prescribed a strong opioid increased considerably nearing the patient's death. About one third of the non‐cancer patients were prescribed strong opioids, mostly commencing in the last 2 weeks before death. In 48% of all patients with an opioid prescription, the GP did not prescribe a laxative.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Weak opioids and laxatives are frequently omitted from pain regimens in palliative care at home in The Netherlands. Copyright © 2008 John Wiley &amp; Sons, Ltd.</jats:p></jats:sec>