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Pharmacovigilance in hospice/palliative care: Rapid report of net clinical effect of metoclopramide

Journal Article


Abstract


  • Background: Understanding the performance of prescribed medications in day-to-day practice is important to minimize harm, maximize clinical benefits, and, eventually, better target the people who are most likely to benefit, especially in hospice/palliative care where there may be limited time to optimize prescribing. Metoclopramide, a benzamide prokinetic antiemetic, is widely used for a number of indications including nausea, vomiting, hiccups, and reflux. It has recently had a new "black box" warning issued by the Food and Drug Administration in relation to tardive dyskinesia to limit use to 12 weeks. Methods: A consecutive cohort of patients from 12 participating centers in two countries who were having metoclopramide initiated had data collected at three time points-baseline, 2 days (clinical benefit), and day 7 (clinical harm). Additionally, harms could be recorded at any time. Results: Of the 53 people included in the cohort, 23 (43%) reported benefit at 48 hours, but only 18 (34%) of these people were still using it one week after commencing it. For the other 5, the medication was ceased due to harms. The most frequent harms were akathisia (n=4), headache (n=4), and abdominal pain (n=4). Nine people (17%) had no clinical benefit and experienced harms. Conclusion: Overall, one in three people gained net clinical benefit at one week. Limiting effects include side-effects that need to be sought actively in clinical care. �� Copyright 2012, Mary Ann Liebert, Inc.

Publication Date


  • 2012

Citation


  • Currow, D. C., Vella-Brincat, J., Fazekas, B., Clark, K., Doogue, M., & Rowett, D. (2012). Pharmacovigilance in hospice/palliative care: Rapid report of net clinical effect of metoclopramide. Journal of Palliative Medicine, 15(10), 1071-1075. doi:10.1089/jpm.2012.0111

Scopus Eid


  • 2-s2.0-84866285154

Start Page


  • 1071

End Page


  • 1075

Volume


  • 15

Issue


  • 10

Place Of Publication


Abstract


  • Background: Understanding the performance of prescribed medications in day-to-day practice is important to minimize harm, maximize clinical benefits, and, eventually, better target the people who are most likely to benefit, especially in hospice/palliative care where there may be limited time to optimize prescribing. Metoclopramide, a benzamide prokinetic antiemetic, is widely used for a number of indications including nausea, vomiting, hiccups, and reflux. It has recently had a new "black box" warning issued by the Food and Drug Administration in relation to tardive dyskinesia to limit use to 12 weeks. Methods: A consecutive cohort of patients from 12 participating centers in two countries who were having metoclopramide initiated had data collected at three time points-baseline, 2 days (clinical benefit), and day 7 (clinical harm). Additionally, harms could be recorded at any time. Results: Of the 53 people included in the cohort, 23 (43%) reported benefit at 48 hours, but only 18 (34%) of these people were still using it one week after commencing it. For the other 5, the medication was ceased due to harms. The most frequent harms were akathisia (n=4), headache (n=4), and abdominal pain (n=4). Nine people (17%) had no clinical benefit and experienced harms. Conclusion: Overall, one in three people gained net clinical benefit at one week. Limiting effects include side-effects that need to be sought actively in clinical care. �� Copyright 2012, Mary Ann Liebert, Inc.

Publication Date


  • 2012

Citation


  • Currow, D. C., Vella-Brincat, J., Fazekas, B., Clark, K., Doogue, M., & Rowett, D. (2012). Pharmacovigilance in hospice/palliative care: Rapid report of net clinical effect of metoclopramide. Journal of Palliative Medicine, 15(10), 1071-1075. doi:10.1089/jpm.2012.0111

Scopus Eid


  • 2-s2.0-84866285154

Start Page


  • 1071

End Page


  • 1075

Volume


  • 15

Issue


  • 10

Place Of Publication