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Indwelling urinary catheters at the end of life are associated with less breakthrough medication use
  1. Benjamin Thomas1,2,
  2. Lucy Hood1,
  3. Sandra Rawson1 and
  4. Wing-Shan Angela Lo1
  1. 1Palliative Care, Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia
  2. 2Graduate Medicine, University of Wollongong, Wollongong, New South Wales, Australia
  1. Correspondence to Dr Benjamin Thomas, Palliative Medicine, Illawarra Shoalhaven Local Health District, Wollongong, NSW 2521, Australia; benjamin.thomas{at}health.nsw.gov.au

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Introduction

At the end of life (EOL), deterioration in the ability to perform bodily functions can be a natural product of the progression of illness. The ability to empty the bladder and bowels decreases as frailty worsens, with unresponsive patients unable to control these bodily processes.

The incidence of catheterisation in palliative care often exceeds 40%1 due to multiple factors including disease progression, frailty, incontinence and urinary retention. Insertion of an indwelling urinary catheter (IDC) is the preferred method to reduce retention, as increasing bladder volumes are uncomfortable, triggering potential pain and agitation. Retention is common in palliative care, with 63% of patients in one study presenting with retention.1

Regular monitoring of bladder volumes for retention should be considered part of EOL care, especially in patients who become agitated and unable to communicate due to physical deterioration,2 as alleviation of retention with an IDC can provide symptomatic relief. It is unclear what the incidence of urinary retention at EOL is, and whether patients with retention are not being identified and are being treated with medications instead of an IDC.

This project aimed to determine the incidence of patients referred to a tertiary hospital palliative care service at EOL who required an IDC and to analyse the pattern of medications given for pain and distress preinsertion and postinsertion, to determine if IDC insertion could …

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Footnotes

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  • Contributors BT designed the project. SR and LH recruited the participants. BT analysed the data. BT and W-SAL drafted the manuscript and all authors had input into the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.