Do-not-resuscitate status is correlated with the prescribed use of systemic strong opioid analgesics in patients with terminal cancer: an observational study.


Journal

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
ISSN: 1433-7339
Titre abrégé: Support Care Cancer
Pays: Germany
ID NLM: 9302957

Informations de publication

Date de publication:
Dec 2019
Historique:
received: 20 09 2018
accepted: 19 03 2019
pubmed: 28 3 2019
medline: 23 11 2019
entrez: 28 3 2019
Statut: ppublish

Résumé

The purpose of this study is to determine the possible correlation between the do-not-resuscitate (DNR) status and the prescribed use of systemic strong opioid analgesics (SSOA) among patients with terminal cancer in Taiwan. This retrospective cross-sectional study used data from a single tertiary care medical center. We identified patients with terminal cancer who died after signing a DNR order between 2008 and 2016. Subsequently, we reviewed their clinical characteristics, DNR consent type, survival time after DNR declaration, and SSOA dose. Of the 4123 patients enrolled for this study, 1380 (33.5%) had received SSOA before DNR and 2742 (66.5%) had received SSOA after DNR (p < 0.001). SSOA doses administered after the DNR order were significantly higher than those administered before the DNR order (median, 78 vs. 60 mg, p < 0.01). Patients' DNR status likely influenced physician decision in prescribing SSOA. However, additional studies are necessary to clarify the factors that influence the decision-making of physicians regarding SSOA prescription.

Identifiants

pubmed: 30915568
doi: 10.1007/s00520-019-04765-6
pii: 10.1007/s00520-019-04765-6
doi:

Substances chimiques

Analgesics, Opioid 0

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

4507-4513

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Auteurs

Chun-Li Wang (CL)

Department of Family Medicine, Taichung Veterans General Hospital, No.1650, Sec. 4, Taiwan Blvd., Xitun Dist., Taichung City, 407, Taiwan, Republic of China.

Chia-Yen Lin (CY)

Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan.
Division of Surgical Critical Care, Department of Critical Care Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.

Chun-Che Huang (CC)

Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.

Chu-Sheng Lin (CS)

Department of Family Medicine, Taichung Veterans General Hospital, No.1650, Sec. 4, Taiwan Blvd., Xitun Dist., Taichung City, 407, Taiwan, Republic of China.
Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan.

Chung-Chieh Hu (CC)

Department of Family Medicine, Taichung Veterans General Hospital, No.1650, Sec. 4, Taiwan Blvd., Xitun Dist., Taichung City, 407, Taiwan, Republic of China.
Division of Palliative Medicine, Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.

Sheau-Feng Hwang (SF)

Department of Obstetrics, Gynecology & Women's Health, Taichung Veterans General Hospital, Taichung, Taiwan.
Palliative Care Unit, Taichung Veterans General Hospital, Taichung, Taiwan.

Ting-Ting Yen (TT)

Palliative Care Unit, Taichung Veterans General Hospital, Taichung, Taiwan.
Department of Otolaryngology, Taichung Veterans General Hospital, Taichung, Taiwan.
School of Medicine, National Yang-Ming University, Taipei, Taiwan.

Yi-Sheng Liou (YS)

Department of Family Medicine, Taichung Veterans General Hospital, No.1650, Sec. 4, Taiwan Blvd., Xitun Dist., Taichung City, 407, Taiwan, Republic of China.

Lung-Chun Lee (LC)

Department of Family Medicine, Taichung Veterans General Hospital, No.1650, Sec. 4, Taiwan Blvd., Xitun Dist., Taichung City, 407, Taiwan, Republic of China. cw1601zx@vghtc.gov.tw.
Division of Palliative Medicine, Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan. cw1601zx@vghtc.gov.tw.

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Classifications MeSH