Considerations of Pharmacotherapy in Hospice End-of-Life Care

Anniek Masman

In 2013 approximately 141,000 persons died in the Netherlands, almost one third of whom from the consequences of cancer, mainly localized in the digestive or respiratory organs. The most reported symptoms in patients with incurable cancer are: fatigue (88%), appetite loss (56%), pain (45%), dyspnoea (39%), drowsiness (38%), dry mouth (34%), constipation (29%), confusion (24%), nausea (17%), and insomnia (14%). The main goal of palliative care is to relieve and control these symptoms by a combination of non-pharmacological measures and a variety of drugs, such as analgesics and sedatives. This regimen may fail to provide adequate symptom relief, however. Then, continuous palliative sedation may be an option of last resort in the last days of life, as proposed by the Royal Dutch Medical Association (KNMG) in a national Guideline Palliative Sedation (2009).

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