DEPRESCRIPTION ON ONCOLOGICAL PALLIATIVE CARE: AN INTEGRATING REVIEW

Patients on Oncologic Palliative Care (OPC), due to diverse symptomatology and variable severity, tend to present polypharmacy that, although it seems justifiable in many cases, can pose health risks and negative consequences on patients’ quality of life. Thus, it is necessary to evaluate the presence of possible therapeutic futilities, guiding the process of deprescription, in which there is a reduction in the amount of medication after reviewing the treatment objectives and assessing risks and benefits. The objective of this study was to identify the main classes of drugs that are candidates for the deprescription for OPC patients by reviewing the literature of the last 8 years. The bibliographic search was performed in the Medline and LILACS databases. Inclusion criteria were articles published between 2010 and 2018, which dealt with the topic of deprescription in OPC. The publications were analyzed for Qualis and the level of scientific evidence, in order to identify the main drugs candidates for deprescription. Twenty articles were evaluated, being only 4 randomized clinical trials (RCTs), with level II of scientific evidence. Among the classes of drugs that are candidates for deprescription, the following stand out: statins (20.37%) and antihypertensives (20.07%). In addition our study show that Drug Related Problem 2 is the one that is most related to the process of deprescription, since it is a prescription medication that the patient does not need, reflecting the inappropriate use of medications, which can result in increased public health expenditures, interactions with other drugs that are a priority for the patient, as well as the occurrence of Adverse Drug Events, which may lead to an increase in the frequency of hospitalizations. RCTs that corroborate with scientific evidence of quality need to be developed for guidelines that make it possible to deprescribe, especially for the population in OPC. We highlight the importance of the use of tools for deprescribe and to identify inappropriate drugs, the use of medication conciliation as a means of identifying them, as well as pharmacotherapeutic follow-up.