title: Medications That Older Adults in Hospice Care in the United States Take, 2007.
abstract: OBJECTIVE
  To describe medications that older adults in hospice with cancer, dementia, debility, heart disease, and lung disease take during the last week of life.
  
  
  METHODS
  Retrospective cross-sectional study.
  
  
  METHODS
  Nationally representative sample of 695 U.S. hospices in the 2007 National Home and Hospice Care Survey.
  
  
  METHODS
  Individuals aged 65 and older with a primary diagnosis of cancer (49%), dementia (12%), debility (14%), heart disease (16%), or lung disease (10%) who received end-of-life care during their last week of life (N = 2,623).
  
  
  METHODS
  Medication data were obtained from hospice staff, who were asked, "What are the names of all the medications and drugs the patient was taking 7 days prior to and on the day of his or her death while in hospice? Please include any standing, routine, or PRN medications."
  
  
  RESULTS
  The unweighted survey response rate was 71%. The average number of medications taken was 10.2. The most common therapeutic classes were analgesics (98%); antiemetic and antivertigo medications (78%); anxiolytics, sedatives, and hypnotics (76%); anticonvulsants (71%); and laxatives (53%). Approximately one-quarter of the individuals took proton pump inhibitors, anticoagulants, and antidepressants, and fewer than 20% took antacids and antibiotics. A smaller percentage of individuals with dementia and debility than of those with cancer took opioid analgesics. Individuals with heart disease were more likely than individuals in the other clinical cohorts to take diuretics, and those with lung disease were more likely than those in the other clinical cohorts to take bronchodilators. A higher percentage of individuals with dementia and with debility than with cancer and lung disease took antidepressants.
  
  
  CONCLUSIONS
  People continue to receive disease-focused therapies at the end of life rather than therapies exclusively for palliation of symptoms, suggesting that treatments may vary according to the person's primary diagnosis.
authors.affiliation: National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland.
authors.forename: Lisa L
authors.initials: LL
authors.lastname: Dwyer
authors.affiliation: National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland.|College of Pharmacy, University of Illinois at Chicago, Chicago, Illinois.|Milken Institute, School of Public Health, George Washington University, Washington, District of Columbia.
authors.forename: Denys T
authors.initials: DT
authors.lastname: Lau
authors.affiliation: VITAS Healthcare, Orlando, Florida.
authors.forename: Joseph W
authors.initials: JW
authors.lastname: Shega
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004358:Drug Therapy / Q000706:statistics & numerical data*; D005260:Female; D017051:Hospice Care; D006801:Humans; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013727:Terminal Care; D014481:United States
keywords: cancer; dementia; heart disease; hospice; medications