Patterns of medication use at end of life by pediatric inpatients with cancer

Abstract

Objective: To describe medication utilization patterns by pediatric inpatients with cancer during their last week of life. Methods: This retrospective study used data from the Vizient Clinical Database/Resource Manager, a national compilation of clinical and resource use data from over 100 academic medical centers and affiliates. Patients (0-21 years) with malignancy who died during hospitalization (2010-2017) were included (N = 1659). Medications were categorized as opioid, benzodiazepine, gastrointestinal related, chemotherapy, anti-infectives, or vasopressors. Exposure to each group was ascertained for all patients at 1 week and 1 day prior to death. Factors associated with exposure were examined using generalized estimating equations, and summarized using adjusted odds ratios (aORs). Results: Over the last week of life, there was increased use of opioids (76% to 82%, aOR = 1.55, P