Pro re nata prescribing in a population receiving palliative care: A prospective consecutive case note review

Russell, BJ; Rowett, D; Currow, DC

Pro re nata prescribing in a population receiving palliative care: A prospective consecutive case note review

Russell, BJ Rowett, D Currow, DC

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Publication Type:: Journal Article
Citation:: Journal of the American Geriatrics Society, 2014, 62 (9), pp. 1736 - 1740
Issue Date:: 2014-01-01

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Field	Value	Language
dc.contributor.author	Russell, BJ	en_US
dc.contributor.author	Rowett, D	en_US
dc.contributor.author	Currow, DC https://orcid.org/0000-0003-1988-1250	en_US
dc.date.issued	2014-01-01	en_US
dc.identifier.citation	Journal of the American Geriatrics Society, 2014, 62 (9), pp. 1736 - 1740	en_US
dc.identifier.issn	0002-8614	en_US
dc.identifier.uri	http://hdl.handle.net/10453/118979
dc.description.abstract	© 2014, The American Geriatrics Society. Objectives To document pro re nata (PRN) prescribing practices and to identify patterns with respect to clinical characteristics and the medications prescribed. Design Prospective consecutive case note review. Setting Two interrelated consultative hospice and palliative care services in regional Victoria, Australia. Participants Terminally ill inpatients and community-based individuals (N = 203) at the time of referral to a hospice or palliative care service. Measurements Number of medications that the referring physician prescribed on a PRN basis and on a regular basis for symptom control; comorbid disease, performance status, comorbidity burden, disease phase, and survival. Results Mean number of PRN medications prescribed was 3.0, with significantly higher rates in the last week of life (rate ratio (RR) = 1.30, 95% confidence interval (CI) = 1.07-1.59) and during the terminal phase of disease (RR = 1.36, 95% CI = 1.09-1.68). One-quarter of prescriptions were for medications that met the Beers consensus criteria for potentially inappropriate medication use in elderly persons. Conclusion These descriptive baseline data are new. A mean of three different medications allows responsiveness to a variety of fluctuating symptoms, but there was a large range within the sample, indicating that some individuals and their caregivers have a high burden of administration-related decision-making.	en_US
dc.relation.ispartof	Journal of the American Geriatrics Society	en_US
dc.relation.isbasedon	10.1111/jgs.12981	en_US
dc.subject.classification	Geriatrics	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Benzodiazepines	en_US
dc.subject.mesh	Analgesics, Opioid	en_US
dc.subject.mesh	Antiemetics	en_US
dc.subject.mesh	Palliative Care	en_US
dc.subject.mesh	Hospice Care	en_US
dc.subject.mesh	Prospective Studies	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Aged, 80 and over	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Terminally Ill	en_US
dc.subject.mesh	Physician's Practice Patterns	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Drug Prescriptions	en_US
dc.subject.mesh	Inappropriate Prescribing	en_US
dc.subject.mesh	Practice Patterns, Physicians'	en_US
dc.title	Pro re nata prescribing in a population receiving palliative care: A prospective consecutive case note review	en_US
dc.type	Journal Article
utslib.citation.volume	9	en_US
utslib.citation.volume	62	en_US
utslib.for	1110 Nursing	en_US
utslib.for	11 Medical and Health Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
utslib.copyright.status	closed_access
pubs.issue	9	en_US
pubs.publication-status	Published	en_US
pubs.volume	62	en_US

Abstract:

© 2014, The American Geriatrics Society. Objectives To document pro re nata (PRN) prescribing practices and to identify patterns with respect to clinical characteristics and the medications prescribed. Design Prospective consecutive case note review. Setting Two interrelated consultative hospice and palliative care services in regional Victoria, Australia. Participants Terminally ill inpatients and community-based individuals (N = 203) at the time of referral to a hospice or palliative care service. Measurements Number of medications that the referring physician prescribed on a PRN basis and on a regular basis for symptom control; comorbid disease, performance status, comorbidity burden, disease phase, and survival. Results Mean number of PRN medications prescribed was 3.0, with significantly higher rates in the last week of life (rate ratio (RR) = 1.30, 95% confidence interval (CI) = 1.07-1.59) and during the terminal phase of disease (RR = 1.36, 95% CI = 1.09-1.68). One-quarter of prescriptions were for medications that met the Beers consensus criteria for potentially inappropriate medication use in elderly persons. Conclusion These descriptive baseline data are new. A mean of three different medications allows responsiveness to a variety of fluctuating symptoms, but there was a large range within the sample, indicating that some individuals and their caregivers have a high burden of administration-related decision-making.

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http://hdl.handle.net/10453/118979