| アブストラクト | BACKGROUND: Haloperidol is widely prescribed as an antiemetic in patients receiving palliative care, but there is limited evidence to support and refine its use. OBJECTIVE: To explore the immediate and short-term net clinical effects of haloperidol when treating nausea and/or vomiting in palliative care patients. DESIGN: A prospective, multicenter, consecutive case series. SETTING/SUBJECTS: Twenty-two sites, five countries: consultative, ambulatory, and inpatient services. MEASUREMENTS: When haloperidol was started in routine care as an antiemetic, data were collected at three time points: baseline; 48 hours (benefits); day seven (harms). Clinical effects were assessed using the National Cancer Institute's Common Terminology Criteria for Adverse Events (NCI CTCAE). RESULTS: Data were collected (May 2014-March 2016) from 150 patients: 61% male; 86% with cancer; mean age 72 (standard deviation 11) years and median Australian-modified Karnofsky Performance Scale 50 (range 10-90). At baseline, nausea was moderate (88; 62%) or severe (11; 8%); 145 patients reported vomiting, with a baseline NCI CTCAE vomiting score of 1.0. The median (range) dose of haloperidol was 1.5 mg/24 hours (0.5-5 mg/24 hours) given orally or parenterally. Five patients (3%) died before further data collection. At 48 hours, 114 patients (79%) had complete resolution of their nausea and vomiting, with greater benefit seen in the resolution of nausea than vomiting. At day seven, 37 (26%) patients had a total of 62 mild/moderate harms including constipation 25 (40%); dry mouth 13 (21%); and somnolence 12 (19%). CONCLUSIONS: Haloperidol as an antiemetic provided rapid net clinical benefit with low-grade, short-term harms. |
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| 投稿者 | Digges, Madeline; Hussein, Akram; Wilcock, Andrew; Crawford, Gregory B; Boland, Jason W; Agar, Meera R; Sinnarajah, Aynharan; Currow, David C; Johnson, Miriam J |
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| 組織名 | 1 Discipline of Palliative Care, School of Medicine, Flinders University ,;Adelaide, South Australia, Australia .;2 Hayward House Specialist Palliative Care Unit, School of Clinical Oncology,;University of Nottingham , Nottingham, England.;3 Northern Adelaide Palliative Service , Northern Adelaide Local Health Network,;4 Discipline of Medicine, University of Adelaide , Adelaide, South Australia,;Australia .;5 Wolfson Palliative Care Research Centre, Hull York Medical School , University;of Hull, Hull, England.;6 IMPACCT-Improving Palliative, Aged and Chronic Care through Clinical Research;and Translation, Faculty of Health, University of Technology Sydney , Sydney, New;South Wales, Australia .;7 Division of Palliative Medicine, Department of Oncology, Cumming School of;Medicine, University of Calgary , Calgary, Alberta, Canada .;8 Palliative/End of Life Care, Alberta Health Services , Calgary, Alberta, Canada;.;9 Southern Adelaide Palliative Services , Adelaide, South Australia, Australia . |
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