Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty of Heinrich, University Hospital Duesseldorf, Heine University Duesseldorf, Moorenstraße 5, 40225, Duesseldorf, Germany.
Interdisciplinary Center for Palliative Medicine, Medical Faculty of Heinrich, University Hospital Duesseldorf, Heine University Duesseldorf, Moorenstrasse 5, 40225, Duesseldorf, Duesseldorf, Germany.
BMC Palliat Care. 2023 Aug 19;22(1):118. doi: 10.1186/s12904-023-01231-3.
According to § 27 and § 87 1b of the German Social Code, Book V, general outpatient palliative care (GOPC) 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 GOPC 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 GOPC treatment within 12 months following GOPC treatment.
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).
The results of this study show, that in the context of general general outpatient palliative care, there is a significant increase in the prescription of opioids (18.3% vs. 37.7%), sedatives (7.8% vs. 16.2%) and antiemetics (5.3% vs. 9.7%), 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%).
Our results support the role of GOPC as an important element in improving pharmacological symptom control and deprescription to improve quality of life of patients at the end of their life.
根据《德国社会法典》第五卷第 27 条和第 87 条 1b 款，普通门诊姑息治疗（GOPC）旨在提高、维持和改善重病患者的生活质量和自主权，使他们能够在自己喜欢的环境中有尊严地走向死亡。与以治愈为目的的方法不同，GOPC 治疗侧重于通过药物或其他措施针对个别病例缓解症状和痛苦，并管理个体化治疗计划。因此，本研究旨在调查 GOPC 治疗后 12 个月内，药物治疗与 GOPC 治疗前 12 个月相比有何不同。
本研究采用基于 IQVIA 疾病分析器（DA）的回顾性数据库横断面研究，纳入 2018 年 1 月 1 日至 2021 年 12 月 31 日期间 805 家普通诊所（GP）中至少有一次姑息支持记录的癌症诊断成年患者。
本研究结果表明，在普通门诊姑息治疗中，阿片类药物（18.3%比 37.7%）、镇静剂（7.8%比 16.2%）和止吐药（5.3%比 9.7%）的处方显著增加，而他汀类药物（21.4%比 11.5%）、质子泵抑制剂（PPI）（41.2%比 35.3%）或抗高血压药（57.5%比 46.6%）等其他药物的处方显著减少。
我们的结果支持 GOPC 作为改善药物治疗控制症状和减少处方以提高终末期患者生活质量的重要手段。
