Use of opioids in geriatric palliative care

analysis of a public hospital in Brazil’s Federal District

Resumen

Introduction: Patients in Geriatric Palliative Care (GPC) complain of pain and opioids are the drugs used to manage it. This study aims to understand the sociodemographic, clinical and opioid use characteristics of GPC patients in a public hospital in the Federal District of Brazil.
Methods: This is a cross-sectional approach based on analysis of prescriptions. The results are shown in tables after descriptive and bivariate analysis. Fisher’s exact test, Bonferroni’s post hoc for categorical variables and Kendall’s tau correlation coefficient for continuous variables were used.
Results: Four hundred and forty-four prescriptions for 49 patients were analyzed. Data showed a mean age of 80.4 years, a prevalence of women (57.1 %), the main diagnoses being Alzheimer’s disease and neoplasia, and prevalent length of up to 7 days. Morphine was the most used medication (15.8 mg to 20.8 mg). The oral route was predominant at the beginning of hospitalization and the subcutaneous route at the end. There was a greater dose variation in degenerative disease of the nervous system and statistical significance between length of stay (1 to 7 days) and clinical diagnosis.
Discussion: The sociodemographic and clinical characteristics are in line with the Brazilian epidemiological profile. The use of opioids was equivalent to that recommended and is more associated with dyspnea control. Dose variation in degenerative nervous system disease probably occurred due to the variability of diseases included in this group. The statistical significance between length of hospitalization and diagnosis can be justified by the clinical severity of the patients hospitalized.