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Symptom management in people dying with COVID-19: multinational observational study

Oluyase, Adejoke Obirenjeyi; Bajwah, Sabrina; Sleeman, Katherine E.; Walshe, Catherine; Preston, Nancy; Hocaoglu, Mevhibe; Bradshaw, Andy; Chambers, Rachel L.; Murtagh, Fliss E.M.; Dunleavy, Lesley; Maddocks, Matthew; Fraser, Lorna K.; Higginson, Irene J.

Authors

Adejoke Obirenjeyi Oluyase

Sabrina Bajwah

Katherine E. Sleeman

Catherine Walshe

Nancy Preston

Mevhibe Hocaoglu

Andy Bradshaw

Rachel L. Chambers

Lesley Dunleavy

Matthew Maddocks

Lorna K. Fraser

Irene J. Higginson



Abstract

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.

Citation

Oluyase, A. O., Bajwah, S., Sleeman, K. E., Walshe, C., Preston, N., Hocaoglu, M., …Higginson, I. J. (2022). Symptom management in people dying with COVID-19: multinational observational study. BMJ Supportive & Palliative Care, 12(4), 439-447. https://doi.org/10.1136/spcare-2022-003799

Journal Article Type Article
Acceptance Date Jul 28, 2022
Online Publication Date Sep 8, 2022
Publication Date 2022-12
Deposit Date Dec 6, 2022
Publicly Available Date Mar 28, 2024
Journal BMJ supportive & palliative care
Print ISSN 2045-435X
Electronic ISSN 2045-4368
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 12
Issue 4
Pages 439-447
DOI https://doi.org/10.1136/spcare-2022-003799
Keywords Medical–Surgical Nursing; Oncology (nursing); General Medicine; Medicine (miscellaneous)
Public URL https://hull-repository.worktribe.com/output/4138837

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