A national registry study to estimate the effect of pharmacotherapy on death rattle in cancer patients

2020 Fiscal Year Final Research Report

• Project/Area Number: 18K15396
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 52010:General internal medicine-related
• Research Institution: University of the Ryukyus
• Principal Investigator: Nobuhisa Nakajima 琉球大学, 病院, 特命准教授 (70749770)
• Project Period (FY): 2018-04-01 – 2021-03-31
• Keywords: 死前喘鳴 / 緩和ケア / がん終末期 / 薬物療法 / 抗コリン薬 / レジストリ研究

Outline of Final Research Achievements

A total of 196 patients who presented with death rattle were included in the analysis. 1) In the study of all patients, there was no significant difference between the use of anticholinergic drugs (Scopolamine hydrobromide, Scopolamine　butylbromide) and the intensity of wheezing. 2) The use of anticholinergic drugs significantly reduced the intensity of wheezing at 12 and 20 hours in patients with a Back scale of 2 or higher than that at T0 (before starting these drugs). There was no significant difference in the type of anticholinergic drug or method of administration (single or continuous).
In terms of anticholinergic medication for death rattle, it is possible to obtain significant improvement by making decisions based on the intensity of the wheezing. In the future, interventional studies should be designed to clarify the differences in the therapeutic effects of anticholinergic drugs and administration methods on death rattle.

Free Research Field

緩和医療学

Academic Significance and Societal Importance of the Research Achievements

今回の研究で得られた成果を、以下に示す①～③のような取り組みに繋げることが、本研究の学術的意義ならびに社会的意義である。
①研究代表者が委員長を務める日本緩和医療学会ガイドライン統括委員会における各種ガイドラインの作成・改訂に反映させる。②適切なデザインの介入研究を行うことにより治療効果を推定する方法論を確立させる。③レジストリ研究による治療効果の推定という点で、高齢者プライマリケアなど、比較試験を行いにくい関連研究領域への研究方法に応用する。