Research shows many patients receive unnecessary medications in final months of life

Many patients in the last three months of life continue to be prescribed medications that provide little benefit or may even pose risks, while sometimes missing treatments they actually need, according to a new study by the Dutch research institute Nivel.

According to AD, the study examined prescriptions for 7,781 people aged 18 and older who died in 2023 and were receiving palliative care. Researchers found that 63 percent of patients were still prescribed medications they had taken in the previous nine months, even though these drugs were no longer considered beneficial at the end of life.

Examples of medications with limited value in the final months include treatments for dementia, bone-strengthening supplements like vitamin D and calcium, and certain cardiovascular medications. In contrast, pain management remains highly beneficial.

Nivel researchers noted that ideally, these prescriptions should be minimized or discontinued, particularly when the risks of taking the medication outweigh the expected benefits. Some drugs, such as those intended for long-term effects, are continued even when patients have limited life expectancy.

Among the study group, 61 percent received some form of pain medication, most commonly opioids. Because opioids often cause constipation, 65 percent of patients were also prescribed laxatives. However, guidelines recommend that patients on strong painkillers should always receive laxatives, regardless of whether they have developed constipation.

Marcel Olde Rikkert, a professor of geriatrics at Radboud University Medical Center in Nijmegen, said predicting the last three months of life remains challenging. “Doctors cannot predict the final three months very well,” he told AD.

He added that medication decisions should be more closely linked to “milestones,” such as a new diagnosis or a sudden increase in care needs.