期刊
BMJ SUPPORTIVE & PALLIATIVE CARE
卷 12, 期 4, 页码 439-447出版社
BMJ PUBLISHING GROUP
DOI: 10.1136/spcare-2022-003799
关键词
COVID-19; Hospice care; Symptoms and symptom management; End of life care; Terminal care
资金
- Medical Research Council [MR/V012908/1]
- National Institute for Health Research (NIHR), Applied Research Collaboration, South London
- Cicely Saunders International [1087195]
- NIHR Applied Research Collaboration (ARC) South London (SL) at King's College Hospital National Health Service Foundation Trust
- National Institute for Health Research (NIHR) Career Development Fellowship [CDF-2017-10-009]
- NIHR ARC SL
- NIHR Career Development Fellowship [CDF-2018-11-ST2-002]
- Cicely Saunders International
458 specialist palliative care services were surveyed regarding symptom management in patients dying with COVID-19. They tended to prescribe opioids and benzodiazepines for breathlessness, benzodiazepines and antipsychotics for agitation, opioids and cough linctus for cough, paracetamol and non-steroidal anti-inflammatory drugs for fever, and opioids and paracetamol for pain.
Objectives To describe multinational prescribing practices by palliative care services for symptom management in patients dying with COVID-19 and the perceived effectiveness of medicines. Methods We surveyed specialist palliative care services, contacted via relevant organisations between April and July 2020. Descriptive statistics for categorical variables were expressed as counts and percentages. Content analysis explored free text responses about symptom management in COVID-19. Medicines were classified using British National Formulary categories. Perceptions on effectiveness of medicines were grouped into five categories; effective, some, limited or unclear effectiveness, no effect. Results 458 services responded; 277 UK, 85 rest of Europe, 95 rest of the world, 1 missing country. 358 services had managed patients with confirmed or suspected COVID-19. 289 services had protocols for symptom management in COVID-19. Services tended to prescribe medicines for symptom control comparable to medicines used in people without COVID-19; mainly opioids and benzodiazepines for breathlessness, benzodiazepines and antipsychotics for agitation, opioids and cough linctus for cough, paracetamol and non-steroidal anti-inflammatory drugs for fever, and opioids and paracetamol for pain. Medicines were considered to be mostly effective but varied by patient's condition, route of administration and dose. Conclusions Services were largely consistent in prescribing for symptom management in people dying with COVID-19. Medicines used prior to COVID-19 were mostly considered effective in controlling common symptoms.
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