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

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dc.contributor.author Currow, David Christopher
dc.contributor.author Vella-Brincat, Jane
dc.contributor.author Fazekas, Belinda Susan
dc.contributor.author Clark, Katherine
dc.contributor.author Doogue, Matthew
dc.contributor.author Rowett, Debra Sharon
dc.date.accessioned 2013-08-09T02:57:41Z
dc.date.available 2013-08-09T02:57:41Z
dc.date.issued 2012-07-20
dc.description.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 sideeffects that need to be sought actively in clinical care. en
dc.identifier.citation Currow, D.C., Vella-Brincat, J., Fazekas, B.S., Clark, K., Doogue, M. and Rowett, D.S., 2012. Pharmacovigilance in hospice/palliative care: rapid report of net clinical effect of metoclopramide. Journal of Palliative Medicine, 15(10), 1071-1075. en
dc.identifier.doi https://doi.org/10.1089/jpm.2012.0111 en
dc.identifier.issn 1096-6218
dc.identifier.uri http://hdl.handle.net/2328/26928
dc.language.iso en
dc.oaire.license.condition.license In Copyright
dc.publisher (C) Mary Ann Liebert, Inc. en
dc.rights.holder © Mary Ann Liebert, Inc. en
dc.subject Palliative care
dc.subject Clinical Pharmacology
dc.title Pharmacovigilance in hospice/palliative care: rapid report of net clinical effect of metoclopramide en
dc.type Article en
local.contributor.authorOrcidLookup Currow, David Christopher: https://orcid.org/0000-0003-1988-1250 en_US
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