Scand J Prim Health Care. 2014 Dec;32(4):187-92. doi: 10.3109/02813432.2014.972068. Epub 2014 Nov 3

Drug treatment at the end of life: An epidemiologic study in nursing homes

Jansen K, Schaufel MA, Ruths S

In a cohort study of 524 patients in three Norwegian nursing homes, diagnoses, drug prescriptions and demographic data were collected from electronic records. On the last day of their life, over 99% of people were prescribed drug treatments, with 74% having palliative drugs either alone (27%) or with curative/preventive drugs (47%). Of these, 73% had an anticholinergic, 71% had morphine, just over a half had midazolam and just under a half had haloperidol prescribed by injection. Palliative drug prescription was associated with nursing home, length of stay over 16 months and a diagnosis of cancer. Most initiations of palliative drugs and withdrawals of curative/preventive drugs took place on the last day of life. This study indicates that Improvements in prescribing at the end-of-life care in nursing homes are needed and imply addressing prognostication and earlier response to palliative needs.

Shortcuts are compiled by Jason Boland