Pharmacovigilance in hospice/palliative care: Net effect of haloperidol for delirium

Crawford, GB; Meera Agar, M; Quinn, SJ; Phillips, J; Litster, C; Michael, N; Doogue, M; Rowett, D; Currow, DC

Pharmacovigilance in hospice/palliative care: Net effect of haloperidol for delirium

Crawford, GB Meera Agar, M

Quinn, SJ Phillips, J

Litster, C Michael, N Doogue, M Rowett, D Currow, DC

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Publication Type:: Journal Article
Citation:: Journal of Palliative Medicine, 2013, 16 (11), pp. 1335 - 1341
Issue Date:: 2013-11-01

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Field	Value	Language
dc.contributor.author	Crawford, GB	en_US
dc.contributor.author	Meera Agar, M https://orcid.org/0000-0002-6756-6119	en_US
dc.contributor.author	Quinn, SJ	en_US
dc.contributor.author	Phillips, J https://orcid.org/0000-0002-3691-8230	en_US
dc.contributor.author	Litster, C	en_US
dc.contributor.author	Michael, N	en_US
dc.contributor.author	Doogue, M	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	2013-11-01	en_US
dc.identifier.citation	Journal of Palliative Medicine, 2013, 16 (11), pp. 1335 - 1341	en_US
dc.identifier.issn	1096-6218	en_US
dc.identifier.uri	http://hdl.handle.net/10453/42164
dc.description.abstract	Introduction: Prescribing practice in hospice/palliative care is largely extrapolated from other areas of clinical practice, with few studies of net medication effects (benefits and harms) in hospice/palliative care to guide prescribing decisions. Hospice/palliative care patients differ in multiple ways from better studied participant groups, hence the applicability of studies in other participant groups is uncertain. Haloperidol, a butyrophenone derivative and dopamine antagonist, is commonly prescribed for nausea, vomiting, and delirium in hospice/palliative care. Its frequent use in delirium occurs despite little evidence of the effect of antipsychotics on the untreated course of delirium. The aim of this study was to examine the immediate and short-term clinical benefits and harms of haloperidol for delirium in hospice/palliative care patients. Method: A consecutive cohort of participants from 14 centers across four countries who had haloperidol commenced for delirium were recruited. Data were collected at three time points: baseline, 48 hours (clinical benefits), and day 10 (clinical harms). Investigators were also able to report clinical harms at any time up to 14 days after it was commenced. Results: Of the 119 participants included, the average dose was 2.1 mg per 24 hours; 42 of 106 (35.2%) reported benefit at 48 hours. Harm was reported in 14 of 119 (12%) at 10 days, the most frequent being somnolence (n=11) and urinary retention (n=6). Seven participants had their medication ceased due to harms (2 for somnolence and 2 for rigidity). Approximately half (55/119) were still being treated with haloperidol after 10 days. Conclusion: Overall, 1 in 3 participants gained net clinical benefit at 10 days. © Copyright 2013, Mary Ann Liebert, Inc. 2013.	en_US
dc.relation.ispartof	Journal of Palliative Medicine	en_US
dc.relation.isbasedon	10.1089/jpm.2013.0230	en_US
dc.subject.classification	Gerontology	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Delirium	en_US
dc.subject.mesh	Haloperidol	en_US
dc.subject.mesh	Antipsychotic Agents	en_US
dc.subject.mesh	Treatment Outcome	en_US
dc.subject.mesh	Palliative Care	en_US
dc.subject.mesh	Questionnaires	en_US
dc.subject.mesh	Risk Factors	en_US
dc.subject.mesh	Prospective Studies	en_US
dc.subject.mesh	Comorbidity	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	Hospices	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Pharmacovigilance	en_US
dc.subject.mesh	Surveys and Questionnaires	en_US
dc.title	Pharmacovigilance in hospice/palliative care: Net effect of haloperidol for delirium	en_US
dc.type	Journal Article
utslib.citation.volume	11	en_US
utslib.citation.volume	16	en_US
utslib.for	1110 Nursing	en_US
utslib.for	1103 Clinical Sciences	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
pubs.organisational-group	/University of Technology Sydney/Strength - CHT - Health Technologies
utslib.copyright.status	open_access
pubs.issue	11	en_US
pubs.publication-status	Published	en_US
pubs.volume	16	en_US

Abstract:

Introduction: Prescribing practice in hospice/palliative care is largely extrapolated from other areas of clinical practice, with few studies of net medication effects (benefits and harms) in hospice/palliative care to guide prescribing decisions. Hospice/palliative care patients differ in multiple ways from better studied participant groups, hence the applicability of studies in other participant groups is uncertain. Haloperidol, a butyrophenone derivative and dopamine antagonist, is commonly prescribed for nausea, vomiting, and delirium in hospice/palliative care. Its frequent use in delirium occurs despite little evidence of the effect of antipsychotics on the untreated course of delirium. The aim of this study was to examine the immediate and short-term clinical benefits and harms of haloperidol for delirium in hospice/palliative care patients. Method: A consecutive cohort of participants from 14 centers across four countries who had haloperidol commenced for delirium were recruited. Data were collected at three time points: baseline, 48 hours (clinical benefits), and day 10 (clinical harms). Investigators were also able to report clinical harms at any time up to 14 days after it was commenced. Results: Of the 119 participants included, the average dose was 2.1 mg per 24 hours; 42 of 106 (35.2%) reported benefit at 48 hours. Harm was reported in 14 of 119 (12%) at 10 days, the most frequent being somnolence (n=11) and urinary retention (n=6). Seven participants had their medication ceased due to harms (2 for somnolence and 2 for rigidity). Approximately half (55/119) were still being treated with haloperidol after 10 days. Conclusion: Overall, 1 in 3 participants gained net clinical benefit at 10 days. © Copyright 2013, Mary Ann Liebert, Inc. 2013.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/29025