title: Changes in Prescribed Drugs Between Admission and the End of Life in Patients Admitted to Palliative Care Facilities.
abstract: The aim of prescribing medication in palliative end-of-life care should be symptom control. Data are lacking regarding the prescription of medication at the end of life.
  
  
  
  To investigate the prescription of medication in patients at the end of life in palliative care facilities.
  
  
  
  An observational multicenter study in 7 inpatient palliative care facilities. Participants were adults with an estimated life expectancy of less than 3 months. The study was conducted from February 1, 2012, to January 1, 2013.
  
  
  
  A total of 155 patients were enrolled. On average, patients were prescribed 6.1 drugs at the moment of admission and 4.6 drugs on the day of death. The prescription of analgesics, psycholeptics, and drugs for functional gastrointestinal disorders increased from admission until death. In general, these are drug classes prescribed for symptom control. All other drug classes decreased between admission and the day of death, including different drug classes for the treatment of comorbid disease, such as anticoagulants, beta-blocking agents, drugs used in diabetes, and lipid-modifying agents.
  
  
  
  A reduction in the total amount of medication is seen between admission and death in the palliative care facilities. Although there is an increase in prescribed symptom-specific medication and a reduction in medication prescribed for comorbid disease, there are still patients dying with medication not used for symptom control. This increases pill burden and indicates that physicians need to develop guidelines and educational programs for decreasing medication for comorbidities at the end of life.
authors.affiliation: Groenhuysen Organisation, Roosendaal, The Netherlands. Electronic address: ronald.vannordennen@radboudumc.nl.
authors.forename: Ronald T C M
authors.initials: RT
authors.lastname: van Nordennen
authors.affiliation: Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: Jan C M
authors.initials: JC
authors.lastname: Lavrijsen
authors.affiliation: Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands.
authors.forename: Malou J A B
authors.initials: MJ
authors.lastname: Heesterbeek
authors.affiliation: Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: Hans
authors.initials: H
authors.lastname: Bor
authors.affiliation: Radboudumc Expertise Centre for Pain and Palliative Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: Kris C P
authors.initials: KC
authors.lastname: Vissers
authors.affiliation: Radboud University Medical Centre, Nijmegen, The Netherlands; Joachim en Anna, Centre for Specialized Geriatric Care Nijmegen, The Netherlands.
authors.forename: Raymond T C M
authors.initials: RT
authors.lastname: Koopmans
mesh_terms: D000368:Aged; D015897:Comorbidity; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D054539:Medication Therapy Management; D010166:Palliative Care; D019338:Polypharmacy; D055553:Prescription Drugs / Q000008:administration & dosage*; D013727:Terminal Care
chemical_list: D055553:Prescription Drugs
keywords: End-of-life care; comorbid disease; medication use