Prescribing for nausea in palliative care : A cross-sectional national survey of Australian palliative medicine doctors

To, Timothy H.M., Agar, Meera, Yates, Patsy, & Currow, David C. (2014) Prescribing for nausea in palliative care : A cross-sectional national survey of Australian palliative medicine doctors. Journal of Palliative Medicine, 17(9), pp. 1032-1036.

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Abstract

Background: Nausea can be a debilitating symptom for patients with a life-limiting illness. While addressing reversible components, nonpharmacological strategies and antiemetics are the main therapeutic option. The choice of medication, dose, and route of administration remain highly variable.

Objective: The aim of this study was to codify the current clinical approaches and quantify any variation found nationally.

Methods: A cross-sectional study utilizing a survey of palliative medicine clinicians examined prescribing preferences for nausea using a clinical vignette. Respondent characteristics, the use of nonpharmacological interventions, first- and second-line antiemetic choices, commencing and maximal dose, and time to review were collected.

Results: Responding clinicians were predominantly working in palliative medicine across a range of settings with a 49% response rate (105/213). The main nonpharmacological recommendation was “small, frequent snacks.” Metoclopramide was the predominant first-line agent (69%), followed by haloperidol (26%), while second-line haloperidol was the predominant agent (47%), with wide variation in other nominated agents. Respondents favoring metoclopramide as first-line tended to use haloperidol second-line (65%), but not vice versa. Maximal doses for an individual antiemetic varied up to tenfold.

Conclusion: For nausea, a commonly encountered symptom in palliative care, clinicians' favored metoclopramide and haloperidol; however, after these choices, there was large variation in antiemetic selection. While most clinicians recommended modifying meal size and frequency, use of other nonpharmacological therapies was limited.

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ID Code: 77727
Item Type: Journal Article
Refereed: Yes
Additional URLs:
DOI: 10.1089/jpm.2013.0610
ISSN: 1557-7740
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000) > Nursing not elsewhere classified (111099)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Nursing
Copyright Owner: Copyright 2014 Mary Ann Liebert, Inc.
Deposited On: 16 Oct 2014 01:41
Last Modified: 17 Oct 2014 00:04

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