Reduction of opioid side effects by prophylactic measures of palliative care team may result in improved quality of life.
OBJECTIVE
In February 2002, the palliative care team was established in Ikeda Municipal Hospital to improve palliative care. We investigated changes in the incidences of side effects related to opioids, and evaluated palliative care team activities.


METHODS
Regarding inpatients for whom narcotics were prescribed in our hospital in the years of 2002 (from October 1, 2002 until September 30, 2003), 2004 (from October 1, 2004 until September 30, 2005), and 2006 (from October 1, 2006 until September 30, 2007), we surveyed the rates at which laxatives or antiemetics were prescribed, frequency of defecation/its state before and after the start of narcotic therapy, frequency of nausea/vomiting, and dietary intake.


RESULTS
The proportions of patients in whom laxatives were simultaneously prescribed during opioid therapy in 2002, 2004, and 2006 were 43.5%, 78.7%, and 75.6%, respectively. The proportions of those in whom antiemetics were combined with opioids were 45.7%, 78.7%, and 78.0%, respectively. The incidences of constipation were 50.0%, 39.3%, and 37.8%, respectively. Those of nausea/vomiting were 30.4%, 21.3%, and 9.8%, respectively. Those of anorexia were 65.3%, 39.4%, and 15.4%, respectively.


CONCLUSIONS
These results suggest that palliative care team activities facilitated appropriate drug prescription during opioid therapy, reducing the appearance of side effects, with likelihood of improved quality of life.
Myotoku
Michiaki
M
Laboratory of Clinical Pharmaceutics, Faculty of Pharmacy, Osaka Ohtani University, Tondabayashi, Osaka, Japan. myoutom@osaka-ohtani.ac.jp
Nakanishi
Akiko
A
Kanematsu
Miwa
M
Sakaguchi
Noriko
N
Hashimoto
Norio
N
Koyama
Fumiko
F
Yamaguchi
Seiji
S
Ikeda
Kenji
K
Konishi
Hiroki
H
Hirotani
Yoshihiko
Y
D000368:Aged; D000701:Analgesics, Opioid / Q000009:adverse effects*; D000855:Anorexia / Q000139:chemically induced; D003248:Constipation / Q000139:chemically induced; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D015994:Incidence; D007297:Inpatients; D008297:Male; D009325:Nausea / Q000139:chemically induced; D010166:Palliative Care; D010348:Patient Care Team; D011788:Quality of Life; D018570:Risk Assessment; D040242:Risk Reduction Behavior; D014839:Vomiting / Q000139:chemically induced
D000701:Analgesics, Opioid