Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Nov 18;13(1):50.
doi: 10.1186/1472-684X-13-50. eCollection 2014.

Corticosteroids in palliative care - perspectives of clinicians involved in prescribing: a qualitative study

Anne Denton  1 , John Shaw  1
Affiliations

Corticosteroids in palliative care - perspectives of clinicians involved in prescribing: a qualitative study

Anne Denton et al. BMC Palliat Care. .

Abstract

Background: Corticosteroids are commonly prescribed in palliative care for alleviation of both specific and non-specific symptoms, but relatively little is known of the perspectives of clinicians and what influences their prescribing in this context. The aim of this study was to explore the experiences and perspectives of those involved in the prescribing of corticosteroids in palliative care.

Methods: Semi-structured interviews were undertaken with 12 medical practitioners and six senior nurses from a sample of six New Zealand hospices to identify their experiences and attitudes regarding the prescribing of corticosteroids. A general inductive approach was used to thematically analyse data.

Results: Five broad themes were identified: the role of corticosteroids in palliative care; indications for corticosteroids; influences on prescribing; use of guidelines; and perceptions of previous study data on prescribing patterns for their hospice. Interviewees regarded these agents as having an important place in in palliative care but expressed a degree of uncertainty about certain aspects of their use. They were concerned about issues such as prescribing for non-specific indications, methods of stopping, and lack of monitoring and reviewing. Guidelines were used routinely by only one of the sample hospices. Corticosteroids tended to be prescribed experientially or by habit, rather than based on evidence-based guidelines.

Conclusions: This study has highlighted differences in the understanding of the place of corticosteroids in palliative care by the clinicians interviewed in this study and different practices, particularly in the treatment of non-specific symptoms and in the use of guidelines. These findings suggest a need for further research and discussion about the role of corticosteroids in palliative care and the development of evidence-based guidelines to assist prescribers.

Keywords: Corticosteroids; Hospices; Palliative care clinicians; Prescribing; Qualitative study.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

    1. Kiani M, Yip AYM, Tuffin PHR, Roberts M, Clifford RM. Dexamethasone use in inpatient palliative care. J Pharm Pract Res. 2011;41:217–220.
    1. Lundstrom SH, Furst CJ. The use of corticosteroids in Swedish palliative care. Acta Oncol. 2006;45:430–437. doi: 10.1080/02841860500401167. - DOI - PubMed
    1. Matsuo N, Morita T, Iwase S. Efficacy and undesirable effects of corticosteroid therapy experienced by palliative care specialists in Japan: a nationwide survey. J Palliat Med. 2011;14:840–845. doi: 10.1089/jpm.2011.0002. - DOI - PubMed
    1. Nauck F, Ostgathe C, Klaschik E, Bausewein C, Fuchs M, Lindena G, Neuwöhner K, Schulenberg D, Radbruch L. Drugs in palliative care: results from a representative survey in Germany. Palliat Med. 2004;18:100–107. doi: 10.1191/0269216304pm852oa. - DOI - PubMed
    1. Twycross R, Bergl S, John S, Lewis K. Monitoring drug use in palliative care. Palliat Med. 1994;8:137–143. doi: 10.1177/026921639400800207. - DOI - PubMed
Pre-publication history
    1. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1472-684X/13/50/prepub

LinkOut - more resources