RT Journal Article
SR Electronic
T1 Symptom management in people dying with COVID-19: multinational observational study
JF BMJ Supportive & Palliative Care
JO BMJ Support Palliat Care
FD British Medical Journal Publishing Group
SP 439
OP 447
DO 10.1136/spcare-2022-003799
VO 12
IS 4
A1 Adejoke Obirenjeyi Oluyase
A1 Sabrina Bajwah
A1 Katherine E Sleeman
A1 Catherine Walshe
A1 Nancy Preston
A1 Mevhibe Hocaoglu
A1 Andy Bradshaw
A1 Rachel L Chambers
A1 Fliss E M Murtagh
A1 Lesley Dunleavy
A1 Matthew Maddocks
A1 Lorna K Fraser
A1 Irene J Higginson
YR 2022
UL http://spcare.bmj.com/content/12/4/439.abstract
AB Objectives To describe multinational prescribing practices by palliative care services for symptom management in patients dying with COVID-19 and the perceived effectiveness of medicines.Methods We surveyed specialist palliative care services, contacted via relevant organisations between April and July 2020. Descriptive statistics for categorical variables were expressed as counts and percentages. Content analysis explored free text responses about symptom management in COVID-19. Medicines were classified using British National Formulary categories. Perceptions on effectiveness of medicines were grouped into five categories; effective, some, limited or unclear effectiveness, no effect.Results 458 services responded; 277 UK, 85 rest of Europe, 95 rest of the world, 1 missing country. 358 services had managed patients with confirmed or suspected COVID-19. 289 services had protocols for symptom management in COVID-19. Services tended to prescribe medicines for symptom control comparable to medicines used in people without COVID-19; mainly opioids and benzodiazepines for breathlessness, benzodiazepines and antipsychotics for agitation, opioids and cough linctus for cough, paracetamol and non-steroidal anti-inflammatory drugs for fever, and opioids and paracetamol for pain. Medicines were considered to be mostly effective but varied by patient’s condition, route of administration and dose.Conclusions Services were largely consistent in prescribing for symptom management in people dying with COVID-19. Medicines used prior to COVID-19 were mostly considered effective in controlling common symptoms.Data are available on reasonable request. Applications for use of the survey data can be made for up to 10 years, and will be considered on a case-by-case basis on receipt of a methodological sound proposal to achieve aims in line with the original protocol. The study protocol is available on request. All requests for data access should be addressed to the chief investigator via the details on the CovPall website (https://www.kcl.ac.uk/cicelysaunders/research/evaluating/covpall-study and palliativecare@kcl.ac.uk) and will be reviewed by the Study Steering Group.