Study finds palliative care patients not receiving right medication

A new review of palliative care services in Australia has found medication errors have impacted patients in the final weeks of their lives.

The paper, published by BMJ Supportive & Palliative Care, saw researchers from New South Wales and the University of South Australia discover mistakes relating to opioid use are three times higher than those reported in other healthcare scenarios.

While opioid use is particularly high in care facilities and the health profession, few studies actually focus on errors made when it comes to administrating the drugs.

The research investigated opioid errors at three inpatient palliative care services in metropolitan New South Wales over the course of two years. The study analysed data between 2013 and 2015 and found that 57 per cent of errors saw patients receive a lower dose of pain relief than they actually required.

This resulted in clinical intervention for a third of the affected patients, most of whom were living with cancer or were aged over 70 years old.

Professor Debra Rowett from UniSA’s School of Pharmacy and Medical Sciences said it was important to discover why these opioid errors occurred in the first place.

“Palliative care clinicians have identified that safe use of opioids is a patient safety priority and this study is an important first step in quantifying and identifying opioid errors,” Professor Rowett said.

“The high rate of errors in palliative care environments compared to other healthcare services most likely reflects the higher volume of opioids such as morphine being used for patients to manage their pain in the last stages of their lives.”

Two thirds of the 55 opioid errors were a result of administration errors, while 35 per cent were due to incorrect morphine dosages. A further 29 per cent were the result of the wrong hydromorphone dosage.

Researchers concluded more needs to be done to understand why these errors occurred and to prioritise fixing these problems in the palliative care setting.

At present, opioids are commonly used in palliative care to manage pain and other health symptoms, most commonly related to those associated with cancer.

The study comes after it was revealed that the dying wishes of thousands of Australians are going unmet due to a lack of palliative medicine specialists in the country.

Just one specialist is available for every 704 patient deaths in Australia annually, according to Palliative Care Australia. They’re calling on the government to make palliative care a bigger priority.

This kind of care is used to try and improve the quality of life for people dying in hospitals and other care facilities, with a focus on the treatments people want to receive in the lead-up to their eventual death.

What do you think? Has someone you’ve known not received the right level of care in a palliative care setting?