Drug Information Needs of Health Care Professionals in Palliative Care: A Retrospective Evaluation of a Palliative Care Drug Information Service



      Drug therapy is an integral part of palliative care but pharmacotherapy can be challenging for health care professionals. Access to information is essential for health care providers to choose the best drug treatment for an individual patient. A drug information service can support health care professionals to obtain appropriate, unbiased information.


      To describe the enquiries to a palliative care drug information service. Objectives are to determine the information needs (including off-label use) of different professional groups and areas of care, to identify subject areas and drug substances for which there is a high need for information.


      Retrospective evaluation of all enquiries to a palliative care drug information service within 24 months from July 2017 to June 2019.


      During the study period, 477 enquiries reached the drug information service, mostly from physicians (59%), followed by pharmacists (31%). Ketamin was the most discussed drug (11%), in general enquiries or corresponding replies mostly contained drugs targeting the nervous system, such as analgesics. Application techniques (26%) was the most relevant category, cancer pain (24%) was the most frequently addressed symptom. About half of the enquiries (48%) dealt with off-label us, regarding an application mode outside the license.


      The information needs on palliative care pharmacotherapy seem to be particularly high among physicians. The demand for information in the area of application technology is particularly apparent and demonstrates a therapeutic gap in terms of availability of suitable preparations as well as necessary information.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Pain and Symptom Management
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • World Health Organization
        Promoting rational use of medicines: core components.
        World Health Organization, Geneva2002
        • Hagemann V
        • Bausewein C
        • Remi C
        Drug use beyond the licence in palliative care: a systematic review and narrative synthesis.
        Palliat Med. 2019; 33: 650-662
        • Poudel A
        • Berry R
        • McCarthy A
        • et al.
        Medication use in older, terminally ill cancer patients: are all medications appropriate? A longitudinal audit.
        Palliat Med. 2019; 33: 1232-1235
        • Hagemann V
        • Bausewein C
        • Rémi C.
        Off-label-prescriptions in daily clinical practice – a cross-sectional national survey of palliative medicine physicians.
        Prog Palliat Care. 2019; : 1-6
      1. Leitlinienprogramm Onkologie. Erweiterte S3-Leitlinie palliativmedizin für patienten mit einer nicht-heilbaren krebserkrankung. Langversion 2.0; August 2019. AWMF-Registernummer: 128/001-OL 2019. Available from: Accessed April 9, 2021.

      2. Hämeen-Anttila K, Kusynová Z, Häkkinen M, (FIP) IPF. Medicines information, strategic development 2017.

        • George B
        • Rao PG.
        Assessment and evaluation of drug information services provided in a South Indian teaching hospital.
        Indian J Pharm. 2005; 37: 315
        • Ghaibi S
        • Ipema H
        • Gabay M.
        ASHP guidelines on the pharmacist's role in providing drug information.
        Am J Health Syst Pharm. 2015; 72: 573-577
      3. Bundesverband Deutscher Krankenhausapotheker e.V. ADKA Arzneimittel-Info-Datenbank 5.0.20 2019. Available at: Accessed April 9, 2021.

        • Leitlinienprogramm Onkologie
        S3 Leitlinie Palliativmedizin für Patienten mit einer nicht heilbaren Krebserkrankung.
        • Atkinson CV
        • Kirkham SR.
        Unlicensed uses for medication in a palliative care unit.
        Palliat Med. 1999; 13: 145-152
        • Eileen Kairuz T
        • Gargiulo D
        • Bunt C
        • Garg S
        Quality, safety and efficacy in the ‘off-label'use of medicines.
        Curr Drug Safety. 2007; 2: 89-95
      4. UKMI. Guidance notes for ranking enquiries. UKMi North West Medicines Information Centre. Available at: Accessed October 8, 2020.

        • Ewers R
        • Bloomer MJ
        • Hutchinson A.
        An exploration of the reliability and usability of two delirium screening tools in an Australian ICU: a pilot study.
        Intensive Crit Care Nurs. 2020; 102919
        • Bartoli F
        • Riboldi I
        • Crocamo C
        • Di Brita C
        • Clerici M
        • Carra G.
        Ketamine as a rapid-acting agent for suicidal ideation: a meta-analysis.
        Neurosci Biobehav Rev. 2017; 77: 232-236
        • DdRV Flôres
        • AA de Toni Sartori
        • Antunes JB
        • Pinto AN
        • Pletsch J
        • TdS Dal Pizzol
        Drug information center: challenges of the research process to answer inquiries in hospital pharmaceutical practices.
        Eur J Hosp Pharm. 2018; (ejhpharm-2017-001417)
        • Kappelle WF
        • Siersema PD
        • Bogte A
        • Vleggaar FP.
        Challenges in oral drug delivery in patients with esophageal dysphagia.
        Expert Opin Drug Delivery. 2016; 13: 645-658
        • Argoff CE
        • Kopecky EA.
        Patients with chronic pain and dysphagia (CPD): unmet medical needs and pharmacologic treatment options.
        Curr Med Res Opin. 2014; 30: 2543-2559
      5. WHO. PPE's new fact sheet on information needs of health professionals 2010. Available at: Accessed April 9, 2021.

        • Fisher JS
        Assessment of the use of a regional drug information service by community pharmacists.
        Can J Hosp Pharm. 1998; 51: 7-12
        • Innes JA
        • Bramley MD
        • Wills S
        The impact of UK Medicines Information services on patient care, clinical outcomes and medicines safety: an evaluation of healthcare professionals’ opinions.
        Eur J Hosp Pharm. 2014; 21: 222-228
        • Melnyk SP
        • Shevchuk MY
        • Remillard JA.
        Impact of the dial access drug information service on patient outcome.
        Ann Pharmacother. 2000; 34: 585-592