Continuous Subcutaneous Infusion Practices of United States Hospices

Abstract 

In hospice organizations, continuous subcutaneous infusion (CSI) is a common medication delivery modality for pain management. Nonetheless, little is known regarding the practices of hospice organizations in their utilization of this technique. We surveyed 3,930 hospice organizations to describe indication, diluents, medications, and other variable factors associated with CSI utilization. Of the 3,930 surveys sent, 907 were returned, yielding a response rate of 24%. Seventy-three percent of hospice organizations surveyed indicated they utilized CSI. The average daily census (ADC) of these hospices was 38.6 ± 61.0. The most common indication for CSI use was palliative management (95%). The most common medication used in CSI was morphine sulfate (97%). These results indicate that CSI utilization may be widespread in hospices and further study regarding this delivery system is warranted.

Keywords:  Hypodermoclysis, clysis, subcutaneous, infusion, pain, opioid, hyaluronidase, morphine, hydromorphone, hospice