- Title
- Pharmacovigilance in hospice/palliative care: rapid report of net clinical effect of metoclopramide
- Creator
- Currow, David C.; Vella-Brincat, Jane; Fazekas, Belinda; Clark, Katherine; Doogue, Matthew; Rowett, Debra
- Relation
- Journal of Palliative Medicine Vol. 15, Issue 10, p. 1071-1075
- Publisher Link
- http://dx.doi.org/10.1089/jpm.2012.0111
- Publisher
- Mary Ann Liebert
- Resource Type
- journal article
- Date
- 2012
- Description
- 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 side effects that need to be sought actively in clinical care.
- Subject
- palliative medicine; hospital care; metoclopramide
- Identifier
- http://hdl.handle.net/1959.13/1294386
- Identifier
- uon:18781
- Identifier
- ISSN:1096-6218
- Language
- eng
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