The following is a summary of “Use of preventive medication and Supplements in general practice in Patients in their Last year of life: a Retrospective cohort study,” published in the April 2023 issue of Primary Care by Antonisse, et al.
As people age, their pharmacokinetics change, drug-drug interactions become more common, and their treatment priorities shift; they may no longer benefit from taking some of the preventative drugs and supplements they formerly did. Unfortunately, there is a lack of data on using these preventative medications and supplements in home-care settings for terminally ill patients. The major objective of this research was to evaluate 4 categories of preventative medications and supplements often used by adult patients with a life-limiting illness who are still living at home during their final year of life. The secondary objectives were to evaluate the time between stopping these medications and mortality based on the reasons given in the patient’s file at the general practitioner’s office.
Their study used a retrospective cohort design, and researchers used data from the Julius General Practitioners’ Network at the University Medical Centre Utrecht. This network includes general practitioners (GPs) from Utrecht and the surrounding area. Patients receiving treatment at home diagnosed with a terminal illness at least a year before death were considered. Researchers employed descriptive statistics to learn more about the study population and the timing of drug and supplement initiation, use, and discontinuation in the last year of life.
In the last year of their lives, 458 out of 666 patients included took some preventative medication. Patients utilized vitamins at a rate of 36%, followed by medications to decrease cholesterol at 35%, calcium supplements at 24%, and bisphosphonates at 9%. 70% of patients stopped taking bisphosphonates, 61% stopped taking calcium supplements, 56% stopped taking vitamins, and 48% stopped taking a cholesterol-lowering medication, with a median time to death of 119, 60, 110, and 65 days, respectively. Patients who experienced adverse effects and had medication reviews had the longest median time between stopping their medicine or supplement and their mortality. Many terminally ill home care patients make poor medication and supplements choices. Timely reviews may aid medication optimization in the terminal year.
Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-023-02049-x
