Pharmacovigilance in Hospice/Palliative Care: Net Effect of Haloperidol for Nausea or Vomiting

Digges, M; Hussein, A; Wilcock, A; Crawford, GB; Boland, JW; Agar, MR; Sinnarajah, A; Currow, DC; Johnson, MJ

Pharmacovigilance in Hospice/Palliative Care: Net Effect of Haloperidol for Nausea or Vomiting

Digges, M Hussein, A Wilcock, A Crawford, GB Boland, JW Agar, MR

Sinnarajah, A Currow, DC

Johnson, MJ

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Publication Type:: Journal Article
Citation:: Journal of Palliative Medicine, 2018, 21 (1), pp. 37 - 43
Issue Date:: 2018-01-01

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Field	Value	Language
dc.contributor.author	Digges, M	en_US
dc.contributor.author	Hussein, A	en_US
dc.contributor.author	Wilcock, A	en_US
dc.contributor.author	Crawford, GB	en_US
dc.contributor.author	Boland, JW	en_US
dc.contributor.author	Agar, MR https://orcid.org/0000-0002-6756-6119	en_US
dc.contributor.author	Sinnarajah, A	en_US
dc.contributor.author	Currow, DC https://orcid.org/0000-0003-1988-1250	en_US
dc.contributor.author	Johnson, MJ	en_US
dc.date.available	2020-05-25T19:24:44Z
dc.date.issued	2018-01-01	en_US
dc.identifier.citation	Journal of Palliative Medicine, 2018, 21 (1), pp. 37 - 43	en_US
dc.identifier.issn	1096-6218	en_US
dc.identifier.uri	http://hdl.handle.net/10453/119248
dc.description.abstract	Copyright © 2018, Mary Ann Liebert, Inc. 2018. Background: Haloperidol is widely prescribed as an antiemetic in patients receiving palliative care, but there is limited evidence to support and refine its use. Objective: To explore the immediate and short-term net clinical effects of haloperidol when treating nausea and/or vomiting in palliative care patients. Design: A prospective, multicenter, consecutive case series. Setting/Subjects: Twenty-two sites, five countries: consultative, ambulatory, and inpatient services. Measurements: When haloperidol was started in routine care as an antiemetic, data were collected at three time points: baseline; 48 hours (benefits); day seven (harms). Clinical effects were assessed using the National Cancer Institute's Common Terminology Criteria for Adverse Events (NCI CTCAE). Results: Data were collected (May 2014-March 2016) from 150 patients: 61% male; 86% with cancer; mean age 72 (standard deviation 11) years and median Australian-modified Karnofsky Performance Scale 50 (range 10-90). At baseline, nausea was moderate (88; 62%) or severe (11; 8%); 145 patients reported vomiting, with a baseline NCI CTCAE vomiting score of 1.0. The median (range) dose of haloperidol was 1.5 mg/24 hours (0.5-5 mg/24 hours) given orally or parenterally. Five patients (3%) died before further data collection. At 48 hours, 114 patients (79%) had complete resolution of their nausea and vomiting, with greater benefit seen in the resolution of nausea than vomiting. At day seven, 37 (26%) patients had a total of 62 mild/moderate harms including constipation 25 (40%); dry mouth 13 (21%); and somnolence 12 (19%). Conclusions: Haloperidol as an antiemetic provided rapid net clinical benefit with low-grade, short-term harms.	en_US
dc.relation.ispartof	Journal of Palliative Medicine	en_US
dc.relation.isbasedon	10.1089/jpm.2017.0159	en_US
dc.subject.classification	Gerontology	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Haloperidol	en_US
dc.subject.mesh	Antiemetics	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	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Pharmacovigilance	en_US
dc.subject.mesh	Hospice and Palliative Care Nursing	en_US
dc.title	Pharmacovigilance in Hospice/Palliative Care: Net Effect of Haloperidol for Nausea or Vomiting	en_US
dc.type	Journal Article
utslib.citation.volume	1	en_US
utslib.citation.volume	21	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	1110 Nursing	en_US
utslib.for	1117 Public Health and Health Services	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	open_access
pubs.issue	1	en_US
pubs.publication-status	Published	en_US
pubs.volume	21	en_US

Abstract:

Copyright © 2018, Mary Ann Liebert, Inc. 2018. Background: Haloperidol is widely prescribed as an antiemetic in patients receiving palliative care, but there is limited evidence to support and refine its use. Objective: To explore the immediate and short-term net clinical effects of haloperidol when treating nausea and/or vomiting in palliative care patients. Design: A prospective, multicenter, consecutive case series. Setting/Subjects: Twenty-two sites, five countries: consultative, ambulatory, and inpatient services. Measurements: When haloperidol was started in routine care as an antiemetic, data were collected at three time points: baseline; 48 hours (benefits); day seven (harms). Clinical effects were assessed using the National Cancer Institute's Common Terminology Criteria for Adverse Events (NCI CTCAE). Results: Data were collected (May 2014-March 2016) from 150 patients: 61% male; 86% with cancer; mean age 72 (standard deviation 11) years and median Australian-modified Karnofsky Performance Scale 50 (range 10-90). At baseline, nausea was moderate (88; 62%) or severe (11; 8%); 145 patients reported vomiting, with a baseline NCI CTCAE vomiting score of 1.0. The median (range) dose of haloperidol was 1.5 mg/24 hours (0.5-5 mg/24 hours) given orally or parenterally. Five patients (3%) died before further data collection. At 48 hours, 114 patients (79%) had complete resolution of their nausea and vomiting, with greater benefit seen in the resolution of nausea than vomiting. At day seven, 37 (26%) patients had a total of 62 mild/moderate harms including constipation 25 (40%); dry mouth 13 (21%); and somnolence 12 (19%). Conclusions: Haloperidol as an antiemetic provided rapid net clinical benefit with low-grade, short-term harms.

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http://hdl.handle.net/10453/119248