Of all people who died in the Netherlands in 2017, three quarters died of a condition that is often associated with a sick bed and a need for palliative care. Almost half of the people in this target group who were registered with a GP until their death received a repeat prescription for medication that had no or questionable value for them in the last three months of life.
This is evident from data from the Information System Palliative Care, set up by Nivel in collaboration with Expertise Centers Palliative Care and Integrated Cancer Center Netherlands.
Medicines that have no or questionable end-of-life value cannot significantly improve or even harm the patient’s health.
Repeat prescription for medication with no or doubtful value more often prescribed in people over 85
Repeat prescriptions for medication with no or questionable end-of-life value were common in 2017. In 45% of the palliative care target group, the GP prescribed a repeat prescription in the last three months of life. In people older than 85 years this percentage was even higher, namely 54%. These repeat prescriptions often involved cholesterol lowering or osteoporosis drugs, such as vitamin D or calcium.
The GP prescribed a prescription for medication of no or questionable value for the first time in 15% of the palliative care target group in the last three months of life. This often involved people who would die from cancer or chronic heart disease. This medication was prescribed for the first time, for example, vitamin B12 / folic acid and iron preparations.
About the project
The aim of the new information system is to use existing national data to gain more insight into the supply and quality of palliative care.
To this end, we link statistics of the cause of death from Statistics Netherlands with, among other things, data from Nivel Care Registrations First Line and the National Basic Register Hospital Care.
At the beginning of 2020, 2017 was the most recent year for which all three data sources contain information. We analyzed a total of data from 7084 patients enrolled in general practice.
To identify the target population for palliative care, we selected data from people who have died from cancer, chronic heart disease, chronic respiratory disease, stroke, chronic kidney disease, chronic liver disease, dementia / senility, neurodegenerative disease, and HIV / AIDS.
Grant provider: ZonMw-Program Palliance
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