The effects of a palliative care program on antidepressant use and continuing maintenance medications in near end-of-life oncology patients (the HEALED study).
BACKGROUND
The use of antidepressants and maintenance medications for cancer patients in a palliative care setting is controversial. The effectiveness of antidepressants and consequences of discontinuing maintenance medications are unknown in this population.


OBJECTIVE
Compare the quality of life of patients taking and not taking antidepressants at entry to a palliative care clinic, and to observe maintenance medication use in this population, along with consequences of stopping them.


METHODS
Prospective, monthly review of medications, quality of life, and hospitalizations were recorded from oncology patients that attended a palliative care clinic. In addition, a retrospective chart review of medications and hospitalizations of oncology patients that did and did not attend a palliative care clinic was performed.


RESULTS
Forty-three prospective patients were enrolled. Patients had similar quality of life whether or not they were taking antidepressants (p = 0.52). Number of maintenance medications at entry and at final evaluation did not change (p = 0.45). No hospitalizations were caused by discontinuation of maintenance medications. QOL of patients did not decline after coming to the clinic based on the baseline and second FACT-G questionnaires (p = 0.84). Fifty-six patients were included in the retrospective portion of this study. The non-palliative care patients had higher proportions of maintenance medications and rates of hospitalizations when compared to the palliative care patients.


CONCLUSIONS
Quality of life is essentially the same between palliative care patients, whether they are receiving antidepressants or not.
University of Cincinnati Medical Center, Cincinnati, OH, USA Hilary.Thomas2@uchealth.com.
Hilary
H
Thomas
Eskenazi Hospital, Indianapolis, IN, USA.
Monica
M
Randolph
University of Cincinnati Medical Center, Cincinnati, OH, USA.
Jane
J
Pruemer
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000473:pathology / Q000628:therapy*; D010166:Palliative Care / Q000379:methods*; D011446:Prospective Studies; D011788:Quality of Life; D012189:Retrospective Studies; D019452:Terminally Ill
D000928:Antidepressive Agents
Palliative care; antidepressants; maintenance medications; oncology; terminally ill