Futile Medication in Palliative Cancer Patients; a Report from the Middle East

Background: Palliative cancer patients suffer from a condition which needs to take many medications for supportive care and comorbid illnesses management. Therefore, they are at risk of drug-rated problems, such as futile medications. We aimed to discover the futile medication occurrence and identification as well as medication futility associated predictor factors. Method: In a prospective cross-sectional study, we included patients with advanced/incurable malignancies admitted to Ala palliative clinic, a charity clinic affiliated to Omid Hospital in Isfahan, Iran, between June ۲۰۱۸ and April ۲۰۱۹. To identify the use of fruitless medicine towards the end of life, we conducted a thorough analysis of the demographic information and prescription lists of terminally ill patients. The phrase "futile drugs" refers to those that are superfluous or redundant, have no significant benefits in terms of illness symptom management or survival time extension, or have a long-term chronic usage. Results: From ۱۳۳ involved patients, ۱۱۴ (۸۵.۷%) were considered to use at least one futile medication (including only administration of unnecessary medications (۷۰%) or both unnecessary and duplicate medication (۳۰%). ۳۵ patients were encountered with ۴۸ medication duplications of the different pharmacological class of medications mostly opioids (۳۳%). According to multivariate logistic regression analysis, the number of drugs and the average time to death were related with the prevalence of medication futility. Conclusion: Palliative cancer patients were exposed to taking futile medications. More different prospective studies are warranted to evaluate the clinical and economic impact of futile medication use in oncology practice.

Keywords:

cancer , Drug therapy , Medical futility , Palliative care