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Whitaker, Adriene Jolene (2008) MEDICATIONS ALS PATIENTS TAKE IN THE LAST SIX MONTHS OF LIFE. Master's Thesis, University of Pittsburgh. (Unpublished)

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Amyotrophic lateral sclerosis (ALS), an incurable neuromuscular disease, causes progressive paralysis resulting in respiratory failure and ultimately death. Although there are only 30,000 people nationwide living with ALS, this population is of significant public health concern as those afflicted with ALS suffer from progressive symptoms of disability, making them a particularly vulnerable population in need of public health advocacy for improved access to medications and care. As the symptoms of disability become increasing acute in the final months of life, achieving the best quality of life possible is of paramount importance. To achieve this, a number of medications exist to both treat the direct and indirect symptoms of ALS.The purpose of this thesis is to examine barriers terminal ALS patients experience in accessing medications, medication trends as ALS patients near death, and the effect of medications on quality of life for ALS patients in the terminal phase of the disease. Literature pertaining to the terminal phase of ALS was reviewed and an analysis of secondary data was performed. The data analyzed for this thesis was from the National Institute of Mental Health grant funded Living with ALS study, which collected medication data in the preceding months before death from terminal ALS patients. For the purposes of this analysis, patient medications were categorized into four domains: ALS treatment medications, palliative medications, mood medications, and other medications. The correlation between the medication domains and sociodemographic and quality of life indicators were investigated. Changes in medications over time were also investigated.Results of the analysis revealed that those with higher incomes and educational attainment were taking significantly fewer palliative medications. Additionally, those on Medicaid were on significantly fewer other medications. Finally, across all medication domains, medication use declined significantly as patients approached imminent death. These findings suggest that the medications used to treat the symptoms of ALS do little to improve symptoms and even less to improve quality of life. Future research recommendations include exploring patients' motivations for discontinuing medications, improving symptom management medications, and improving ALS patients' access to both pharmacological and non-pharmacological interventions to improve overall quality of life.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Whitaker, Adriene
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairAlbert, Stevensmalbert@pitt.eduSMALBERT
Committee MemberLacomis, Davidlacomisd@pitt.eduLACOMISD
Committee MemberTerry, Martha Annmaterry@pitt.eduMATERRY
Committee MemberYoo, Seunghyunsyoo@pitt.eduSYOO
Date: 31 January 2008
Date Type: Completion
Defense Date: 27 November 2007
Approval Date: 31 January 2008
Submission Date: 6 December 2007
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Behavioral and Community Health Sciences
Degree: MPH - Master of Public Health
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: ALS; End of Life; medications
Other ID:, etd-12062007-173103
Date Deposited: 10 Nov 2011 20:08
Last Modified: 15 Nov 2016 13:53


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