Influence of palliative care on medication: results of a retrospective analysis of 10,464 outpatients in Germany

Abstract

Abstract Background According to § 27 and § 87 1b of the German Social Code, Book V, outpatient palliative care (OPC) aims to promote, maintain, and improve the quality of life and self-determination of seriously ill people. It should enable them to live in dignity until death in their preferred environment. Instead of a curative approach OPC treatment focuses on the multiprofessional objective of alleviating symptoms and suffering on a case-by-case basis using medication or other measures, as well as the management of an individual treatment plan. The aim of this study was therefore to investigate to what extent medication differs from 12 months prior OPC treatment within 12 months following OPC treatment. Methods A retrospective database cross sectional study based on the IQVIA Disease Analyzer (DA) was performed, including adult patients with cancer diagnosis and at least one documentation of palliative support between January 1st, 2018 and December 31st, 2021, in 805 general practices (GP). Results The results of this study show, that in the context of OPC, there is a significant increase in the prescription of opioids (37.7% vs. 18.3%), sedatives (16.2% vs. 7.8%) and antiemetics (9.7% vs. 5.3%), as well as a significant reduction in other medications such as statins (21.4% vs. 11.5%), proton pump inhibitors (PPI) (41.2% vs. 35.3%), or antihypertensives (57.5% vs. 46.6%). Conclusions Our results support the role of OPC as an important element in improving pharmacological symptom control and deprescription to improve quality of life of patients at the end of their life.