A Cost and Quality Analysis of Utilizing a Rectal Catheter for Medication Administration in End-of-Life Symptom Management

Figures & data

Figure 1. Hospice inpatient unit (HIU) medication PPD cost, June 2016 to May 2017.

Figure 2. Average 6-month infusion costs in the HIU.

Figure 3. Cumulative cost of parenteral morphine infusion versus oral morphine delivered by rectal catheter.

Figure 4. Cost comparison of suppository versus rectal catheter.

Table 1. Clinical benefits of the rectal catheter.

Rapid symptom resolution

Fulfill patient’s wish to remain home

Preemptive symptom management

Reduce caregiver breakdown

Reduced clinical staff/office coordination time

Discreet medication administration

Reduced staff medication administration time (HIU setting)

Potential discharge plan to home care (HIU setting)

Maintain home-like atmosphere (HIU setting)

Less controlled substances present for shift counts (HIU setting)

Note. HIU = hospice inpatient unit.

Table 2. Contraindications and challenges to rectal catheter use.

Contraindication	Challenges
Rectal tumors	Soft stool in rectum and subsequent stooling
Rectal lesions	Lack of PK and dose adjustment data for PR administration
Recent bowel surgery	Hospice culture, staff acceptance
Diarrhea	Patient/caregiver nonpreference of rectal administration
	Perceived “nonaggressive” symptom management

Note. PK = pharmacokinetic; PR = rectal.