Futile medication use in terminally ill cancer patients.
BACKGROUND
Cancer patients usually take many medications. The proportion of patients with advanced cancer who are taking futile drugs is unknown.


METHODS
We retrospectively reviewed the charts of all consecutive ambulatory patients with advanced cancer and who were receiving supportive care exclusively at palliative care clinics, Princess Margaret Hospital, to gather information on futile medications used by them. Futile medications were defined as unnecessary (when no short-term benefit to patients with respect to survival, quality of life, or symptom control was anticipated) or duplicate (two or more drugs from the same pharmacological class). Summary statistics were used to describe the results.


RESULTS
From November 2005 to July 2006, 82 (22%) of 372 patients were taking at least one futile medication before consultation; after initial consultation, this proportion dropped to 20% (78): 70 patients were taking unnecessary medications, while eight were on duplicate medications. The most frequent unnecessary medications used by patients were statins (56%). The most common duplicate medication involved the use of two different benzodiazepines (seven patients).


CONCLUSIONS
About one fifth of cancer outpatients at the end of life take futile medications, most commonly statins. Prospective and population-based studies are warranted to further evaluate the magnitude and consequences of futile medication use in oncology.
Riechelmann
Rachel P
RP
Department of Internal Medicine, Federal University of Sao Paulo, R: Luisiania 255, Apt 11, São Paulo, SP 04560-020, Brazil. rachelri@terra.com.br
Krzyzanowska
Monika K
MK
Zimmermann
Camilla
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D001569:Benzodiazepines / Q000627:therapeutic use; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008297:Male; D018447:Medical Futility; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000401:mortality; D010166:Palliative Care / Q000379:methods* / Q000592:standards; D011788:Quality of Life; D012189:Retrospective Studies; D055815:Young Adult
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D001569:Benzodiazepines