완화 돌봄 전환 이후의 노인 말기 암환자의 약물 사용 변화

초록

Background: Polypharmacy is becoming increasingly common among older patients, including those with advanced cancer, presenting multiple challenges. However, recommendations for managing polypharmacy in older patients with cancer near the end of life have not yet been standardized. This study aimed to evaluate the medication prescriptions of older patients with cancer at a hospice and palliative care center in Korea to help develop new clinical practice guidelines for polypharmacy management. Methods: We retrospectively reviewed the medical charts of 46 older patients with terminal cancer who died at the Hospice-Palliative Care Center of a teaching hospital in Korea between January 1, 2019, and December 31, 2020. We assessed the prescribed medications at four points in time from the day of transfer to the day of death. Essential medications were checked based on the International Association for Hospice and Palliative Care (IAHPC) list of essential palliative care medicines. Results: The total numbers of drugs at the transfer day, 2 weeks before death, 1 week before death, and the day of death were 10.9 (3.82), 8.5 (3.28), 7.70 (2.75), and 5.74 (2.37), respectively. In addition, the numbers of non-IAHPC essential drugs were 8.00 (3.78), 5.48 (3.02), 4.70 (2.50), and 3.04 (1.90), respectively. Conclusion: Our data suggest that the total number of drugs decreases and the proportion of IAHPC essential medicines increases among older patients with cancer near the end of life admitted to a hospice and palliative care center.

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