This Article Full Text (PDF) All Versions of this Article: 0269216309106461v1 23/7/623    most recent References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Scopus Google Scholar Articles by Nikles, J. Articles by Currow, D. PubMed PubMed Citation Articles by Nikles, J. Articles by Currow, D. Social Bookmarking                         What's this?

Prioritising drugs for single patient (n-of-1) trials in palliative care

Discipline of General Practice, The University of Queensland, Brisbane, Queensland, uqjnikle{at}uq.edu.au

G. Mitchell

Discipline of General Practice, The University of Queensland, Brisbane, Queensland

J. Walters

Discipline of General Practice, The University of Queensland, Brisbane, Queensland

J. Hardy

The University of Queensland, Brisbane, Queensland, Mater Hospital Palliative Care Services, South Brisbane, Queensland

P. Good

Department of Palliative Care, Calvary Mater Newcastle, NSW, University of Newcastle, Australia, NSW

D. Rowett

Drug and Therapeutics Information Service, Repatriation General Hospital, South Australia

T. Shelby-James

Palliative Care Clinical Studies Collaborative, South Australia and D Currow Flinders University, South Australia

D. Currow

Flinders University, South Australia

Many of the drugs prescribed commonly to palliative care patients have potentially significant side-effects and are of unproven benefit. The acquisition of evidence to support the prescribing of these drugs has been very slow. Single patient trials (SPTs) (also known as n-of-1 trials) offer a potential means of obtaining the evidence necessary to support or refute the use of several of the drugs and interventions whose use is currently based on physician experience or anecdote alone. A list of SPTs considered "most urgent", for commonly employed treatments and for the most common and most troublesome symptoms in palliative care is presented. These are drugs for which the gap between evidence and practice is greatest, where the evidence of efficacy is most lacking, where significant side effects potentially lead to the greatest morbidity, or where cost is a major patient burden. Although not all the drugs used in palliative care are suitable, SPTs provide a potential alternative method of gathering evidence in palliative care.

Key Words: drug • medication • n-of-1 trials • palliative care

This version was published on October 1, 2009

Palliative Medicine, Vol. 23, No. 7, 623-634 (2009)
DOI: 10.1177/0269216309106461


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?