Palliative patients who may benefit from intranasal delivery of symptomatic drugs: a two-center observational study evaluated the administration of morphine and dexamethasone in Polish hospices

Introduction: Patients who are receiving hospice care often have various ailments and may need to take medications to relieve symptoms for the rest of their lives. The most common and recommended way to take morphine and streoids is orally, less frequently, subcutaneous or intravenous routes are used in palliative care. The intranasal route is a relatively uncommon but interesting alternative for administering drugs. Aim: The study aims to identify palliative patients who may benefit from changing the standard opioid and steroid administration route to intranasal delivery. Material and methods: The electronic medical records of all home and inpatient hospice patients were analyzed between February and April 2024. The study focused on the magnitude and type of problems associated with taking medications via standard routes and assessed the potential for changing to an intranasal route of administration. Results: Out of 282 patients who met the inclusion criteria, 95 (43%) were eligible for analysis. According to a survey, 87% of patients experienced issues with taking medications through the standard route. Among the problems related to oral medicines, consciousness disorders were the most significant at 66%. For subcutaneous administration, the main issues were reluctance to inject at 19% and lack of cooperation from caregivers at 20%. Conclusion: The profile of a palliative patient who may benefit from intranasal administration of symptomatic drugs includes patients with impaired consciousness, aversion to subcutaneous injections, and inadequate support from caregivers.