dc.contributor.author | Boland, Jason W. | |
dc.contributor.author | Allgar, Victoria | |
dc.contributor.author | Boland, Elaine G. | |
dc.contributor.author | Agar, Meera | |
dc.contributor.author | Currow, David C. | |
dc.contributor.author | Johnson, Miriam J. | |
dc.contributor.author | Oviasu, Osaretin | |
dc.date.accessioned | 2019-07-10T08:22:43Z | |
dc.date.available | 2019-07-10T08:22:43Z | |
dc.date.issued | 2017-05-23 | |
dc.identifier.citation | Boland, J. W., Allgar, V., Boland, E. G., Oviasu, O. U. I, Agar, M., Currow, D. C., & Johnson, M. J. (2017). Effect of Opioids and Benzodiazepines on Clinical Outcomes in Patients Receiving Palliative Care: An Exploratory Analysis. Journal of Palliative Medicine, 20(11), pp. 1274–1279. | en |
dc.identifier.issn | 1557-7740 | |
dc.identifier.uri | http://eprints.whiterose.ac.uk/117462/ | |
dc.identifier.uri | https://www.dora.dmu.ac.uk/handle/2086/18194 | |
dc.identifier.uri | https://hull-repository.worktribe.com/output/451069) | |
dc.description | The author's final peer reviewed version is available from the URI link. The Publisher's final version can be found by following the DOI link. | en |
dc.description.abstract | Background: Medications for symptom management in palliative care have associated, but poorly understood,
harms. Drug-related harms have important clinical implications,may impact on patients’ compliance and contribute
to symptoms.
Objective: To explore the longitudinal relationship between oral morphine equivalent daily dose (MEDD) and
oral diazepam equivalent daily dose (DEDD) with functional, cognitive, and symptom outcomes in patients
receiving palliative care.
Design: Secondary longitudinal analysis of cancer decedents (n = 235) was carried out from a palliative care
randomized controlled trial with multiple outcome measures. At each time point, MEDD and DEDD were
calculated. Multilevel modeling was used to investigate independent associations between MEDD and DEDD,
and cognitive and gastrointestinal symptoms, quality of life (QoL), performance status, and survival.
Setting/Subjects: Participants were recruited from a specialist palliative care program in southern Adelaide,
were expected to live ‡48 hours, had pain in the previous 3 months, and a baseline Folstein Mini-Mental Status
Examination score ‡25.
Results: Cognitive and gastrointestinal symptoms, performance status, and QoL worsened over time. In the
adjusted multilevel analysis, statistically significant relationships remained between MEDD/DEDD and worsening
performance status ( p = 0.001), DEDD and gastrointestinal effects ( p < 0.001), MEDD and QoL ( p < 0.022).
Conclusions: Commonly used palliative medications were associated with deteriorating performance status.
The lack of association between MEDD with gastrointestinal or cognitive symptoms underlines that these
associations are not inevitable with close attention. This analysis highlights the importance of including other
medications as confounders when exploring medication-related harms. An understanding of the risk–benefit
balance of medications is needed to maximize net benefits for patients. | en |
dc.language.iso | en | en |
dc.publisher | Elsevier | en |
dc.subject | opioids | en |
dc.subject | benzodiazepines | en |
dc.subject | palliative | en |
dc.subject | cancer | en |
dc.subject | symptoms | en |
dc.subject | disease trajectory | en |
dc.subject | survival | en |
dc.subject | quality of life | en |
dc.subject | adverse medication events | en |
dc.title | Effect of Opioids and Benzodiazepines on Clinical Outcomes in Patients Receiving Palliative Care: An Exploratory Analysis | en |
dc.type | Article | en |
dc.identifier.doi | https://doi.org/10.1089/jpm.2017.0129 | |
dc.peerreviewed | Yes | en |
dc.funder | Other external funder (please detail below) | en |
dc.cclicence | CC-BY-NC | en |
dc.date.acceptance | 2017-04-26 | |
dc.exception.reason | available from York Uni repository | en |
dc.exception.ref2021codes | 254a | en |
dc.funder.other | Australian Department of Health and Ageing Palliative Care Branch as part of the National Palliative Care Strategy | en |