title: Medication Needs Vary for Terminally Ill Vietnam Era Veterans With and Without a Diagnosis of PTSD.
abstract: This retrospective pilot study aims to evaluate the clinical impact of palliative care in the treatment of terminally ill Vietnam Veterans with a history of posttraumatic stress disorder (PTSD) versus those without PTSD, as it pertains to medications for symptom control at the end of life (EOL). Active prescriptions for benzodiazepines, hypnotics, antidepressants, and antipsychotic medications at the EOL were recorded. During EOL care, 28 (72%) participants with PTSD used these medications versus 55 (40%) of the non-PTSD participants (P = .0005). There was significant correlation between a lifetime diagnosis of PTSD with antidepressant use (P = .0002) and hypnotics (P = .0085) during EOL care but not with benzodiazepines or antipsychotics. The higher utilization of certain medication classes among participants with PTSD may indicate that PTSD treatment should continue at the EOL to improve care.
authors.affiliation: The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
authors.forename: Esther
authors.initials: E
authors.lastname: Kelley-Cook
authors.affiliation: Baylor Scott & White Health Care System, Temple, TX, USA.
authors.forename: George
authors.initials: G
authors.lastname: Nguyen
authors.affiliation: South Texas Veterans Health Care System, San Antonio, TX, USA.
authors.forename: Shuko
authors.initials: S
authors.lastname: Lee
authors.affiliation: South Texas Veterans Health Care System, San Antonio, TX, USA.
authors.forename: Tressia M
authors.initials: TM
authors.lastname: Edwards
authors.affiliation: The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA South Texas Veterans Health Care System, San Antonio, TX, USA Sanchezreill@uthscsa.edu.
authors.forename: Sandra
authors.initials: S
authors.lastname: Sanchez-Reilly
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D015897:Comorbidity; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D008297:Male; D001523:Mental Disorders / Q000150:complications; D008875:Middle Aged; D010348:Patient Care Team; D010865:Pilot Projects; D012189:Retrospective Studies; D012944:Social Support; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000188:drug therapy*; D019452:Terminally Ill; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans; D047829:Vietnam Conflict
chemical_list: D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D006993:Hypnotics and Sedatives
keywords: Vietnam Veterans; end of life; palliative care; pharmacotherapy; posttraumatic stress disorder (PTSD); terminal care