The American journal of hospice & palliative care最新文献_第3页

Aggressive End-of-Life Treatments Among Inpatients With Cancer and Non-cancer Diseases Using a Japanese National Claims Database. 使用日本国家索赔数据库对癌症和非癌症疾病住院患者进行积极的临终治疗。

The American journal of hospice & palliative care Pub Date : 2024-11-01 Epub Date: 2023-11-29 DOI: 10.1177/10499091231216888

Shintaro Togashi, Kento Masukawa, Maho Aoyama, Kazuki Sato, Mitsunori Miyashita

{"title":"Aggressive End-of-Life Treatments Among Inpatients With Cancer and Non-cancer Diseases Using a Japanese National Claims Database.","authors":"Shintaro Togashi, Kento Masukawa, Maho Aoyama, Kazuki Sato, Mitsunori Miyashita","doi":"10.1177/10499091231216888","DOIUrl":"10.1177/10499091231216888","url":null,"abstract":"To describe aggressive treatments at end-of-life among inpatients with cancer and non-cancer diseases and to evaluate factors associated with these treatments using the Japanese national database (NDB). We conducted a retrospective cohort study among inpatients aged ≥ 20 years who died between 2012 and 2015 using a sampling dataset of NDB. The outcome was the proportion of aggressive treatments in the last 14 days of life. We considered the underlying causes of death as cancer, dementia/senility, and heart, cerebrovascular, renal, liver, respiratory, and neurodegenerative diseases. We analyzed 54,105 inpatients, with underlying cause of death distributed as follows: cancer, 24.9%; heart disease, 16.5%; respiratory disease, 12.3%; and cerebrovascular disease, 9.7%. The proportion of intensive care unit (ICU) admission was 9.7%, being the highest in heart disease (20.5%), followed by cerebrovascular diseases (12.6%), and least in dementia/senility (.6%). The proportion of cardiopulmonary resuscitation was 19.6%, being the highest in heart disease (38.1%), followed by renal diseases (19.5%), and least in cancer (6.2%). Multivariate logistic regression analysis revealed that having heart diseases, cerebrovascular diseases, younger age, less comorbidities, and shorter length of stay were associated with an increasing risk of aggressive treatments in the last 14 days of life. The proportion of aggressive treatments at the end-of-life varies depending on the disease; additionally, these treatments were associated with having heart diseases, younger age, less comorbidity, and shorter length of stay. Our findings may help develop and set benchmarks for quality indicators at the end-of-life for patients with non-cancer diseases.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138465296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

In-Hospital Code Status Updates: Trends Over Time and the Impact of COVID-19. 院内代码状态更新：院内代码状态更新：随时间变化的趋势和 COVID-19 的影响。

The American journal of hospice & palliative care Pub Date : 2024-11-01 Epub Date: 2023-12-18 DOI: 10.1177/10499091231222188

Amirreza Sahebi-Fakhrabad, Eda Kemahlioglu-Ziya, Robert Handfield, Stacy Wood, Mehul D Patel, Cristen P Page, Lydia Chang

{"title":"In-Hospital Code Status Updates: Trends Over Time and the Impact of COVID-19.","authors":"Amirreza Sahebi-Fakhrabad, Eda Kemahlioglu-Ziya, Robert Handfield, Stacy Wood, Mehul D Patel, Cristen P Page, Lydia Chang","doi":"10.1177/10499091231222188","DOIUrl":"10.1177/10499091231222188","url":null,"abstract":"Objective: The primary objective was to evaluate if the percentage of patients with missing or inaccurate code status documentation at a Trauma Level 1 hospital could be reduced through daily updates. The secondary objective was to examine if patient preferences for DNR changed during the COVID-19 pandemic.Methods: This retrospective study, spanning March 2019 to December 2022, compared the code status in ICU and ED patients drawn from two data sets. The first was based on historical electronic medical records (EHR), and the second involved daily updates of code status following patient admission.Results: Implementing daily updates upon admission was more effective in ICUs than in the ED in reducing missing code status documentation. Around 20% of patients without a specific code status chose DNR under the new system. During COVID-19, a decrease in ICU patients choosing DNR and an increase in full code (FC) choices were observed.Conclusion: This study highlights the importance of regular updates and discussions regarding code status to enhance patient care and resource allocation in ICU and ED settings. The COVID-19 pandemic's influence on shifting patient preferences towards full code status underscores the need for adaptable documentation practices. Emphasizing patient education about DNR implications and benefits is key to supporting informed decisions that reflect individual health contexts and values. This approach will help balance the considerations for DNR and full code choices, especially during health care crises.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138812694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of Visitor Restrictions on the Pain and Psychological Wellbeing of Palliative Care Patients: A Cohort Study. 探视限制对姑息治疗患者疼痛和心理健康的影响：一项队列研究

The American journal of hospice & palliative care Pub Date : 2024-11-01 Epub Date: 2024-01-18 DOI: 10.1177/10499091241227241

Yiran Tu, Mark Tacey, Jaclyn Yoong

{"title":"Impact of Visitor Restrictions on the Pain and Psychological Wellbeing of Palliative Care Patients: A Cohort Study.","authors":"Yiran Tu, Mark Tacey, Jaclyn Yoong","doi":"10.1177/10499091241227241","DOIUrl":"10.1177/10499091241227241","url":null,"abstract":"Aim: Palliative care patients with advanced or life-threatening illnesses in hospital during the COVID-19 pandemic are likely to be affected by visitor restrictions (VR). We aimed to explore the impact of VR on patients' levels of physical pain and psychological distress. Design: Retrospective cohort study comparing two cohorts of patients admitted to a palliative care unit in a major metropolitan hospital in Australia; the first cohort from 1 April to 30 June 2019 (pre-pandemic; n = 96), and the second from 1 April to 30 June 2020 (during pandemic; n = 95). Methods: Patient-rated pain scores (using the Symptom Assessment Scale; SAS) and clinician-rated pain and psychological/spiritual severity scores (using the Palliative Care Problem Severity Score; PCPSS) on admission and on discharge or death were compared between pre-pandemic and pandemic cohorts. Discharge pain scores and change in scores from admission to discharge were also assessed via multivariable analyses. Results: Case-mix of patients in both cohorts were similar. After adjusting for demographics and functional status, pain scores in the pandemic cohort were higher for patients deceased on discharge, compared to the pre-pandemic cohort (SAS: coefficient = 0.86, 95%CI: 0.09 to 1.64, P = 0.029; PCPSS: coefficient = 0.24, 95%CI: -0.07 to 0.86, P = 0.131, respectively). Differences in SAS and PCPSS pain and psychological/spiritual scores for those discharged alive were not statistically significant. Conclusion: Among palliative care inpatients affected by VR, we observed higher pain scores for patients discharged deceased; suggesting that VR may have impacted the physical wellbeing (pain) of these patients.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139492877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Determinants of Inpatient Palliative Care Use in Patients With Pancreatic Cancer. 胰腺癌患者住院姑息治疗使用的决定因素

The American journal of hospice & palliative care Pub Date : 2024-11-01 Epub Date: 2023-11-22 DOI: 10.1177/10499091231218257

Osayande Osagiede, Kapil Nayar, Massimo Raimondo, Vivek Kumbhari, Frank J Lukens

{"title":"The Determinants of Inpatient Palliative Care Use in Patients With Pancreatic Cancer.","authors":"Osayande Osagiede, Kapil Nayar, Massimo Raimondo, Vivek Kumbhari, Frank J Lukens","doi":"10.1177/10499091231218257","DOIUrl":"10.1177/10499091231218257","url":null,"abstract":"Introduction: Symptom burden management is a major goal of pancreatic cancer care given that most patients are diagnosed late. Early palliative care is recommended in addition to concurrent active treatment; however, disparities exist. We sought to determine the factors associated with inpatient palliative treatment among pancreatic cancer patients and compare treatment outcomes in terms of mortality, discharge disposition and resource utilization.Methods: We conducted a retrospective study of 22,053 pancreatic cancers using the National Inpatient Sample (NIS) database (January - December 2020). Patient and hospital characteristics, mortality, discharge disposition, length of stay (LOS), hospital costs and charges were compared between pancreatic cancer patients based on palliative treatment. Multivariate regression was used to evaluate patient and hospital characteristics and outcomes associated with palliative treatment.Results: A total number of 3839 (17.4%) patients received palliative care. Patients who received palliative care were more likely to be older, Medicaid insured, and nonobese. Patients were less likely to receive palliative care if they are males, Medicare insured, had a lower Charlson comorbidity score, or treated in Urban nonteaching hospitals. Patients who received palliative care displayed higher odds of in-hospital mortality and prolonged LOS. The adjusted additional mean hospital cost and charges in patients who received palliative care were lower by $1459, and $4222 respectively.Conclusions: Inpatient palliative treatment in pancreatic cancer patients is associated with an older age, a higher comorbidity burden, non-obesity, insurance status and urban teaching hospitals. Our study suggests that inpatient palliative treatment decreased hospital resource utilization without prolonging survival.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138296835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Perceptions on Use of Opioids in Palliative Care of Dyspnoea in Patients with Fibrotic interstitial lung disease and Chronic Obstructive Pulmonary Disease: A Qualitative Study. 纤维化间质性肺病和慢性阻塞性肺病患者在缓解治疗中使用阿片类药物治疗呼吸困难的看法：定性研究。

The American journal of hospice & palliative care Pub Date : 2024-11-01 Epub Date: 2024-02-07 DOI: 10.1177/10499091241227556

Camilla Yde Hvelplund, Birgit Refsgaard, Elisabeth Bendstrup

{"title":"Perceptions on Use of Opioids in Palliative Care of Dyspnoea in Patients with Fibrotic interstitial lung disease and Chronic Obstructive Pulmonary Disease: A Qualitative Study.","authors":"Camilla Yde Hvelplund, Birgit Refsgaard, Elisabeth Bendstrup","doi":"10.1177/10499091241227556","DOIUrl":"10.1177/10499091241227556","url":null,"abstract":"Background: Many patients with chronic obstructive pulmonary disease and fibrotic interstitial lung disease suffer from severe dyspnea and reduced quality of life, despite receiving optimal disease-modifying treatment for their illness. Studies have suggested that these patients may benefit from treatment with low-dose opioids. However, many patients decline opioid treatment. This has led to patients not receiving proper palliative treatment of their lung disease.Aim: To identify potential barriers that prevent patients from receiving adequate palliative care with opioids and enable doctors to address patients' concerns.Design: A qualitative study based on semi-structured interviews. Interviews were transcribed and thematic analysis was done using NVivo.Setting/participants: Patients were recruited when scheduled for out-patient follow-up at Center for Rare Lung Diseases or at the COPD clinic, Aarhus University Hospital. Eligible patients were 18 years of age, did not currently receive opioids or had ever received opioids for dyspnea.Results: A total of 28 patients participated. One patient was excluded before final analysis of 27 patients. Four themes were identified: Fear of side-effects, Need for more information, Stigma of opioids association with severe illness and dying, and No discernible barriers. Furthermore, three sub-themes to Fear of side-effects were identified: Fear of addiction, concern for sedative effect, and fear for loss of mobility due to inability to drive a car. The most expressed concern was Fear of side-effects, especially addiction.Conclusions: Pre-conceived notions about opioids prevent some patients with chronic obstructive lung disease or interstitial lung disease from receiving palliative care for breathlessness.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139704316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ecology of End-of-life Medical Care for Advanced Cancer Patients in China. 中国晚期癌症患者临终医疗生态

The American journal of hospice & palliative care Pub Date : 2024-11-01 Epub Date: 2023-11-28 DOI: 10.1177/10499091231219254

Fei Yang, Anli Leng, Jun Jing, Mary Miller, Bee Wee

{"title":"Ecology of End-of-life Medical Care for Advanced Cancer Patients in China.","authors":"Fei Yang, Anli Leng, Jun Jing, Mary Miller, Bee Wee","doi":"10.1177/10499091231219254","DOIUrl":"10.1177/10499091231219254","url":null,"abstract":"Aims: Cancer is a leading cause of death worldwide. Approximately 30% of global cancer-related deaths occur in mainland China. However, there is a paucity of information regarding the end-of-life care-seeking behavior of patients with advanced cancer in China. Our study was to investigate end-of-life care-seeking behavior and to quantify the association between sociodemographic characteristics and the location and pattern of end-of-life care.Methods: We conducted a mortality follow-back survey using caregivers' interviews to estimate the number of individuals pre 1000 who died between 2013 and 2021 in the last 3 months of life. We collected data on hospitalization, outpatient visits, cardiopulmonary resuscitation, palliative care and hospice utilization, and place of death, stratified by age, gender, marital status, household income, residential zone, insurance type, and the primary end-of-life decision-maker of the decedents.Results: We analyzed data from 857 deceased cancer patients, representing an average of 1000 individuals. Among these patients, 861 experienced at least moderate or more severe pain, 774 were hospitalized at least once, 468 received intensive treatment, 389 had at least one outpatient visit, 270 died in the hospital, 236 received cardiopulmonary resuscitation and 99 received specialist hospice care.Conclusions: Our study provides insights into the end-of-life care-seeking behavior of advanced cancer patients in China and our findings serve as a useful benchmark for estimating the use of end-of-life medical care. It highlights the need for the establishment of an accessible and patient-centered palliative care and hospice system.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138453431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

What Matters Most: The Documented Goals, Values and Motivators of Advanced Cancer Patients. 什么最重要？记录晚期癌症患者的目标、价值观和动机。

The American journal of hospice & palliative care Pub Date : 2024-11-01 Epub Date: 2023-12-19 DOI: 10.1177/10499091231223144

Ashley Aller, Aida Shirazi, Leon Pedell, Andrea Altschuler, Karen Hauser, Megan Cheslock, Jenny Wei, Ali Duffens, Hannah Whitehead, Peggy Lim, Jed Katzel, Francisco Martinez, Amy Lin, Steve Aller, Cynthia Aller, Tyler Jones, Sue May Yen, Raymond Liu

{"title":"What Matters Most: The Documented Goals, Values and Motivators of Advanced Cancer Patients.","authors":"Ashley Aller, Aida Shirazi, Leon Pedell, Andrea Altschuler, Karen Hauser, Megan Cheslock, Jenny Wei, Ali Duffens, Hannah Whitehead, Peggy Lim, Jed Katzel, Francisco Martinez, Amy Lin, Steve Aller, Cynthia Aller, Tyler Jones, Sue May Yen, Raymond Liu","doi":"10.1177/10499091231223144","DOIUrl":"10.1177/10499091231223144","url":null,"abstract":"Background: Goals of care conversations are essential to delivery of goal concordant care. Infrequent and inconsistent goals of care documentation potentially limit delivery of goal concordant care.Methods: At Kaiser Permanente San Francisco Cancer Center, a standardized documentation template was designed and implemented to increase goals of care documentation by oncologists. The centralized, prompt-based template included value clarification of the goals and values of advanced cancer patients beyond treatment preferences. Documented conversations using the template during the initial pilot period were reviewed to characterization the clinical context in which conversations were recorded. Common goals and motivators were also identified.Results: A total of 178 advanced cancer patients had at least 1 documented conversation by a medical oncologist using the goals of care template. Oncologists consistently documented within the template goals of therapy and motivating factors in decision making. The most frequently documented goals of care were \"Avoiding Pain and Suffering,\" \"Physical Independence,\" and \"Living as Long as Possible.\" The least recorded goal was \"Comfort Focused Treatment Only.\"Conclusions: Review of oncologist documented goals of care conversations using a prompt-based template allowed for characterization of the clinical context, therapy goals and motivators of advanced cancer patients. Communication of goals of care conversations by oncologists using a standardized prompt-based template within a centralized location has the potential to improve delivery of goal concordant care.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138812732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ketamine for Super-Refractory Status Epilepticus in Palliative Care. A Case Report and Review of the Literature. 氯胺酮在姑息治疗中的超难治性癫痫持续状态。一例病例报告及文献回顾。

The American journal of hospice & palliative care Pub Date : 2024-10-01 Epub Date: 2023-11-20 DOI: 10.1177/10499091231215491

Edward J Dunn, David D Willis

引用次数: 0

Management of Critical Glucose Values in Hospice. 安宁疗护中的临界血糖值管理。

The American journal of hospice & palliative care Pub Date : 2024-10-01 Epub Date: 2023-12-21 DOI: 10.1177/10499091231223748

Belal Dakroub, Sandra L DiScala, Christine M Vartan, Maura F Miller, Michael Silverman, Swati Chalavarya

{"title":"Management of Critical Glucose Values in Hospice.","authors":"Belal Dakroub, Sandra L DiScala, Christine M Vartan, Maura F Miller, Michael Silverman, Swati Chalavarya","doi":"10.1177/10499091231223748","DOIUrl":"10.1177/10499091231223748","url":null,"abstract":"Objectives: This quality improvement (QI) project was to lean the process for managing critical high and low glucose levels in the hospice unit and to simplify the pharmacologic options for hypoglycemic management for nursing staff. Methods: The process for developing and refining the recommendations involved a modified Delphi approach with a team of key stakeholders with overlapping expertise in hospice care practice. Recommendations were based on literature review, judgement of experts, and clinical experience. Stakeholders ranked six potential solutions and two were prioritized within the scope of this project. Results: From 1/1/21 - 12/31/21, there were 48 veterans with insulin sliding scale orders in the hospice unit, of which there were six critical values acted on. A standard operating procedure (SOP) for the management of critical glucose values in hospice was developed based on updated processes. In addition, hospice patient specific insulin sliding scale order sets were created and endorsed for utilization and dissemination. Following implementation on 3/1/22, no critical values were found in the hospice unit from 3/1/22 - 6/1/22 during the sustainment period. Conclusions: The implementation of hospice insulin sliding scale order sets and SOP on the management of critical glucose values in hospice reduced the number of critical glucose values.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Medication Use Evaluation of Docusate Sodium in Constipation Prophylaxis and Opioid Induced Constipation at the WPB VA HCS Community Living Center. 多休塞特钠在WPB VA HCS社区生活中心预防便秘和阿片类药物引起的便秘中的用药评价

The American journal of hospice & palliative care Pub Date : 2024-10-01 Epub Date: 2023-11-24 DOI: 10.1177/10499091231218390

Wesley Faulkner, Sandra DiScala, Christine Vartan, Belal Dakroub, Michael Silverman, Mythili Bharadwaj

{"title":"Medication Use Evaluation of Docusate Sodium in Constipation Prophylaxis and Opioid Induced Constipation at the WPB VA HCS Community Living Center.","authors":"Wesley Faulkner, Sandra DiScala, Christine Vartan, Belal Dakroub, Michael Silverman, Mythili Bharadwaj","doi":"10.1177/10499091231218390","DOIUrl":"10.1177/10499091231218390","url":null,"abstract":"Introduction: Docusate sodium's efficacy is widely debated. Several studies on opioid induced constipation (OIC) concluded that docusate sodium vs either placebo or in combination with sennosides provided no benefit.Objective: This medication use evaluation aimed to investigate constipation treatment trends within the West Palm Beach VA Healthcare System Community Living Center, and to assess the therapeutic effectiveness of docusate sodium.Methods: This was a retrospective review of data extracted from April 1, 2022, to September 30, 2022. Patients were included if they had oral orders for docusate sodium, sennosides, lactulose, and/or polyethylene glycol. Patients without active bowel regimen medications were excluded. Requirements for rescue constipation medication was evaluated.Results: A total of 98 patients were reviewed. Docusate sodium was used in 43% (n = 42/98) of patients. Rescue medications were needed in 58% (n = 22/38) of patients receiving oral docusate sodium. 52% (n = 29/56) of patients without docusate sodium required rescue medications. For OIC treatment, when docusate sodium was added to other bowel regimens, 59% (n = 17/29) of patients needed a rescue medication, while 66% (n = 19/29) of patients without docusate sodium required a rescue medication. Patients on morphine were given the greatest quantity of rescue constipation medications (73%, n = 16/22).Conclusion: Oral docusate sodium did not reduce the requirement for rescue constipation medications in the WPB VAHCS CLC population. When evaluating constipation treatment, docusate sodium may supply minimal benefit and could be identified as nonessential for deprescribing efforts. Morphine was the most constipating opioid used in this patient population, requiring more aggressive bowel regimens.","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138300891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0