Premium
Medications That Older Adults in Hospice Care in the United States Take, 2007
Author(s) -
Dwyer Lisa L.,
Lau Denys T.,
Shega Joseph W.
Publication year - 2015
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.13795
Subject(s) - medicine , debility , dementia , disease , cancer , lung cancer , pediatrics , intensive care medicine , ophthalmology
Objectives To describe medications that older adults in hospice with cancer, dementia, debility, heart disease, and lung disease take during the last week of life. Design Retrospective cross‐sectional study. Setting Nationally representative sample of 695 U.S. hospices in the 2007 National Home and Hospice Care Survey. Participants 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). Measurements 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. Conclusion 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.