Effects of opioids and sedatives on survival in an Australian inpatient palliative care population

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Abstract:

Abstract Aims:

To assess whether opioid and sedative medication use affects survival (from hospice admission to death) of patients in an Australian inpatient palliative care unit. Background:

Retrospective audit. Newcastle Mercy Hospice – a tertiary referral palliative care unit. All patients who died in the hospice between 1 February and 31 December 2000. Methods:

Length of survival from hospice admission to death, and the median and mean doses of opioids and sedatives used in the last 24 h of life. Comparison of these with published studies outside of Australia. Results:

In this study, the use of opioids, benzodiazepines and haloperidol did not have an association with shortened survival and the only statistical significant finding was an increased survival in patients who were on 300 mg/day or more of oral morphine equivalent (OME). The proportion of patients requiring greater than or equal to 300 mg OME/day (at 28%) was higher than published studies, but the mean dose of 371 mg OME/day was within the range of other studies. The proportion of patients receiving sedatives (94%) was higher than other studies, but the median dose of parenteral midazolam equivalent of 12.5 mg per 24 h was lower than other studies from outside Australia. Conclusions:

There was no association between the doses of opioids and sedatives on the last day of life and survival (from hospice admission to death) in this population of palliative care patients. (Intern Med J 2005; 35: 512–517)

Keywords: double effect; hypnotics and sedatives; narcotics; palliative care; survival analysis; therapeutic use

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1445-5994.2005.00888.x

Affiliations: Division of Palliative Care, Newcastle Mater Misericordiae Hospital, Waratah and Faculty of Health, University of Newcastle, Callaghan, New South Wales, Australia

Publication date: September 1, 2005

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