Abstract:
BACKGROUND:The evidence supporting pharmacological treatment of death rattle is poor; yet, anticholinergic drugs feature in end-of-life care pathways and guidelines worldwide as a treatment option. AIM:This qualitative arm of a wider study aimed to explore important issues which health-care professionals associated with decision-making to prescribe or administer anticholinergics at the end of life. DESIGN:After purposive sampling, five focus groups were conducted. Discussions were audiotaped and transcribed verbatim. SETTING:Thirty medical and nursing personnel working in inpatient and community settings from two specialist palliative care units in the United Kingdom took part in the study. RESULTS:Thematic analysis of transcripts from audiotapes revealed perceived pressures to prescribe and/or administer anticholinergics from colleagues and carers, and drugs were often prescribed or administered in order to be seen to 'do something', although the benefit in terms of therapeutic response was considered minimal. Familiarity with drug regimens and dosing was often based on personal experience. The monitoring of side effects of anticholinergics at the end of life was recognised as problematic and had little influence on prescribing and administration. There was also an indication that patients and carers in the community were more likely to receive timely verbal preparation and explanation around death rattle than those cared for in an inpatient setting. CONCLUSION:The study raises questions about the routine inclusion of anticholinergic treatment in UK end of life care pathways for the treatment of death rattle.
journal_name
Palliat Medjournal_title
Palliative medicineauthors
Hirsch CA,Marriott JF,Faull CMdoi
10.1177/0269216312464407subject
Has Abstractpub_date
2013-09-01 00:00:00pages
732-8issue
8eissn
0269-2163issn
1477-030Xpii
0269216312464407journal_volume
27pub_type
杂志文章abstract:INTRODUCTION:This research examines 2006 population-based data on persons who died in US nursing homes (NHs) and received hospice in the NH. METHODS:We compared dying persons characteristics and lengths of hospice stay in five US states between 1992 and 1996 and in 2006. We also compared characteristics of dying perso...
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