Practice review: Evidence-based quality use of corticosteroids in the palliative care of patients with advanced cancer.

Hardy, J; Haywood, A; Rickett, K; Sallnow, L; Good, P

Practice review: Evidence-based quality use of corticosteroids in the palliative care of patients with advanced cancer.

Hardy, J Haywood, A Rickett, K Sallnow, L Good, P

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Publisher:: SAGE Publications
Publication Type:: Journal Article
Citation:: Palliative Medicine, 2021, 35, (3), pp. 461-472
Issue Date:: 2021-03

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Field	Value	Language
dc.contributor.author	Hardy, J
dc.contributor.author	Haywood, A
dc.contributor.author	Rickett, K
dc.contributor.author	Sallnow, L
dc.contributor.author	Good, P https://orcid.org/0000-0002-8198-0375
dc.date.accessioned	2022-03-21T02:53:34Z
dc.date.available	2022-03-21T02:53:34Z
dc.date.issued	2021-03
dc.identifier.citation	Palliative Medicine, 2021, 35, (3), pp. 461-472
dc.identifier.issn	0269-2163
dc.identifier.issn	1477-030X
dc.identifier.uri	http://hdl.handle.net/10453/155406
dc.description.abstract	BACKGROUND: It would be unusual for a patient with advanced cancer not to be prescribed corticosteroids at some stage of their disease course for a variety of specific and non-specific indications. AIM: The aim of this practice review was to provide a pragmatic overview of the evidence supporting current practice and to identify areas in which further research is indicated. DESIGN: A 'state-of-the-art' review approach was used to examine the evidence supporting the use of corticosteroids for the management of cancer-related complications and in symptom control, in the context of known risks and harms to inform quality use of this medicine. We developed 'Do', 'Do not', and 'Don't know' recommendations based on current literature and identified areas for future investigation and research. DATA SOURCES: We searched MEDLINE, EMBASE and the Cochrane library from inception to 14th October 2020. Our initial search limited to reviews, reviews of reviews, randomised controlled trials (RCTs) and controlled trials was supplemented by supporting literature as appropriate. RESULTS: Evidence to support common practice in the use of corticosteroids is lacking for most indications. This is in the context of strong evidence for the potential for significant toxicity and poor quality use of medicine. CONCLUSION: Guidelines recommending the widespread use of corticosteroids should acknowledge the poor evidence base supporting much current dogma. Quality research is essential not only to define the role of corticosteroids in this context but to ensure good prescribing practice.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	SAGE Publications
dc.relation.ispartof	Palliative Medicine
dc.relation.isbasedon	10.1177/0269216320986717
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1117 Public Health and Health Services, 1199 Other Medical and Health Sciences
dc.subject.classification	Gerontology
dc.subject.mesh	Adrenal Cortex Hormones
dc.subject.mesh	Disease Progression
dc.subject.mesh	Hospice and Palliative Care Nursing
dc.subject.mesh	Humans
dc.subject.mesh	Neoplasms
dc.subject.mesh	Palliative Care
dc.subject.mesh	Adrenal Cortex Hormones
dc.subject.mesh	Disease Progression
dc.subject.mesh	Hospice and Palliative Care Nursing
dc.subject.mesh	Humans
dc.subject.mesh	Neoplasms
dc.subject.mesh	Palliative Care
dc.subject.mesh	Humans
dc.subject.mesh	Neoplasms
dc.subject.mesh	Disease Progression
dc.subject.mesh	Adrenal Cortex Hormones
dc.subject.mesh	Palliative Care
dc.subject.mesh	Hospice and Palliative Care Nursing
dc.title	Practice review: Evidence-based quality use of corticosteroids in the palliative care of patients with advanced cancer.
dc.type	Journal Article
utslib.citation.volume	35
utslib.location.activity	England
utslib.for	1117 Public Health and Health Services
utslib.for	1199 Other Medical and Health Sciences
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
utslib.copyright.status	closed_access	*
pubs.consider-herdc	false
dc.date.updated	2022-03-21T02:53:33Z
pubs.issue	3
pubs.publication-status	Published
pubs.volume	35
utslib.citation.issue	3

Abstract:

BACKGROUND: It would be unusual for a patient with advanced cancer not to be prescribed corticosteroids at some stage of their disease course for a variety of specific and non-specific indications. AIM: The aim of this practice review was to provide a pragmatic overview of the evidence supporting current practice and to identify areas in which further research is indicated. DESIGN: A 'state-of-the-art' review approach was used to examine the evidence supporting the use of corticosteroids for the management of cancer-related complications and in symptom control, in the context of known risks and harms to inform quality use of this medicine. We developed 'Do', 'Do not', and 'Don't know' recommendations based on current literature and identified areas for future investigation and research. DATA SOURCES: We searched MEDLINE, EMBASE and the Cochrane library from inception to 14th October 2020. Our initial search limited to reviews, reviews of reviews, randomised controlled trials (RCTs) and controlled trials was supplemented by supporting literature as appropriate. RESULTS: Evidence to support common practice in the use of corticosteroids is lacking for most indications. This is in the context of strong evidence for the potential for significant toxicity and poor quality use of medicine. CONCLUSION: Guidelines recommending the widespread use of corticosteroids should acknowledge the poor evidence base supporting much current dogma. Quality research is essential not only to define the role of corticosteroids in this context but to ensure good prescribing practice.

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http://hdl.handle.net/10453/155406