Sammanfattning
Objective. To examine drug treatment in nursing home patients at the end of life, and identify
predictors of palliative drug therapy. Design. A historical cohort study. Setting. Three urban nursing
homes in Norway. Subjects. All patients admitted from January 2008 and deceased before February
2013. Main outcome measures. Drug prescriptions, diagnoses, and demographic data were collected
from electronic patient records. Palliative end-of-life drug treatment was defined on the basis of
indication, drug, and formulation. Results. 524 patients were included, median (range) age at death
86 (19-104) years, 59% women. On the day of death, 99.4% of the study population had active
prescriptions; 74.2% had palliative drugs either alone (26.9%) or concomitantly with
curative/preventive drugs (47.3%). Palliative drugs were associated with nursing home, length of stay
> 16 months (AOR 2.10, 95% CI 1.12-3.94), age (1.03, 1.005-1.05), and a diagnosis of cancer (2.12,
1.19-3.76). Most initiations of palliative drugs and withdrawals of curative/preventive drugs took
place on the day of death. Conclusion. Palliative drug therapy and drug therapy changes are common
for nursing home patients on the last day of life. Improvements in end-of-life care in nursing homes
imply addressing prognostication and earlier response to palliative needs.