Commonly Prescribed Medications Among Patients in Hospice Care for Chronic Obstructive Pulmonary Disease.
OBJECTIVE
End-stage chronic obstructive pulmonary disease (COPD) presents health care providers with challenges of providing optimal palliative care for patients who follow a less predictable trajectory. The objectives of this study were to evaluate medications being prescribed to patients with end-stage COPD, compared to recommendations made by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines, and to determine which medications were provided by the hospice organization.


METHODS
We retrospectively reviewed our database for medications pertaining to COPD management as stated in the GOLD criteria or those used for symptoms associated with end of life.


RESULTS
A total of 745 patients met inclusion criteria, and approximately 63% were prescribed opioids. Prescribing rates for oxygen, short-acting β2-agonists, and short-acting anticholinergics were 37%, 33%, and 31%, respectively. Systemic and inhaled corticosteroids were prescribed at higher rates of 20% and 18% compared to long-acting bronchodilators.


CONCLUSIONS
Medications used for COPD exacerbation management were prescribed at higher rate than those used for maintenance treatment.
Department of Pharmacy Services, MedStar Union Memorial Hospital, Baltimore, MD, USA.
Mary
M
Afrane
Department of Pharmacy Practice and Science, University of Maryland School of Pharmacy, Baltimore, MD, USA lsera@rx.umaryland.edu.
Leah
L
Sera
Department of General Internal Medicine/Healthy Aging Clinic, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Holly M
HM
Holmes
Department of Pharmacy Practice and Science, University of Maryland School of Pharmacy, Baltimore, MD, USA.
Mary L
ML
McPherson
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D019983:Guideline Adherence; D017051:Hospice Care / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D010102:Oxygen Inhalation Therapy / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000628:therapy; D012189:Retrospective Studies
D000305:Adrenal Cortex Hormones; D001993:Bronchodilator Agents
bronchodilators; chronic obstructive pulmonary disease; end of life; hospice care; opioids; palliative care