Medication misuse and illicit substance use among palliative care patients in German palliative care units- an evaluation from the perspective of palliative care providers.
Jannis Eersink, Julian Maul, Nils Heuser, Astrid Morin, Martin Gschnell, Christian Volberg
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引用次数: 0
Abstract
Background: Palliative care focuses on controlling symptoms and improving the patient's quality of life. To achieve this, medications with addictive potential are often used. There have been various case reports of substance misuse in palliative care. This study aims to explore how practitioners perceive the issue and management of substance misuse in palliative care patients.
Materials and methods: Following an extensive literature review, a 23-question questionnaire was developed to assess attitudes and practices related to substance misuse in palliative care and distributed to all German palliative care units (PCUs) listed on the website of the German Society for Palliative Medicine (n = 334).
Results: A total of 116 responses from PCUs (34.7%) were included in the analysis. Of these, 49.1% estimated that approximately 1-5% of their patients suffer from medication-related substance misuse. Most respondents (72.4%) assumed that 1-5% of their patients use illicit substances. In addition, 62.9% of the PCUs do not screen their patients for substance use disorders, while only 0.9% report doing so regularly. In the case of addiction problems, 55.2% of the PCUs do not implement any specific measures. Most respondents described their approach to prescribing medications with potential for substance misuse as liberal (71.6%) or very liberal (12.9%). Furthermore, 78.4% reported that the addictive potential of a medication has little or no influence on their prescribing decisions. Finally, 67.2% of participants expressed a desire for more education about addiction in palliative care.
Discussion: The data collected in our study indicate that, from the perspective of palliative care professionals, substance use disorders are not perceived as a significant problem for patients receiving inpatient palliative care. However, we found that most PCUs do not screen their patients for substance misuse, suggesting that most practitioners may not have a comprehensive view of the actual number of dependent patients. Further research is therefore needed to obtain reliable data on the number of patients with substance use disorders in palliative care and to determine the point at which substance misuse is caused by medical prescription.
期刊介绍：
Addiction Science & Clinical Practice provides a forum for clinically relevant research and perspectives that contribute to improving the quality of care for people with unhealthy alcohol, tobacco, or other drug use and addictive behaviours across a spectrum of clinical settings.
Addiction Science & Clinical Practice accepts articles of clinical relevance related to the prevention and treatment of unhealthy alcohol, tobacco, and other drug use across the spectrum of clinical settings. Topics of interest address issues related to the following: the spectrum of unhealthy use of alcohol, tobacco, and other drugs among the range of affected persons (e.g., not limited by age, race/ethnicity, gender, or sexual orientation); the array of clinical prevention and treatment practices (from health messages, to identification and early intervention, to more extensive interventions including counseling and pharmacotherapy and other management strategies); and identification and management of medical, psychiatric, social, and other health consequences of substance use.
Addiction Science & Clinical Practice is particularly interested in articles that address how to improve the quality of care for people with unhealthy substance use and related conditions as described in the (US) Institute of Medicine report, Improving the Quality of Healthcare for Mental Health and Substance Use Conditions (Washington, DC: National Academies Press, 2006). Such articles address the quality of care and of health services. Although the journal also welcomes submissions that address these conditions in addiction speciality-treatment settings, the journal is particularly interested in including articles that address unhealthy use outside these settings, including experience with novel models of care and outcomes, and outcomes of research-practice collaborations.
Although Addiction Science & Clinical Practice is generally not an outlet for basic science research, we will accept basic science research manuscripts that have clearly described potential clinical relevance and are accessible to audiences outside a narrow laboratory research field.
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