This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related letters  • Related article  • Similar articles in JAMA  Topic Collections  • Aging/ Geriatrics  • End-of-life Care/ Palliative Medicine  • Rehabilitation Medicine  • Anemias  • Alert me on articles by topic

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: In their Perspectives on Care at the Close of Life, Drs Boockvar and Meier¹ discuss palliative care for frail older adults and state that "relief of discomfort and enhancement of quality of life is highly appropriate." They recommend considering megestrol as a treatment and cite Reuben et al²; however, that study did not find a statistically significant effect of megestrol acetate on serum albumin levels or clinical end points, such as weight, functional status, or health-related quality of life. They also cite Yeh et al,³ who found no difference in weight change until months after treatment was stopped, no difference in depression scores, and a 3-point difference on a 99-point scale of sense of well-being. As Boockvar and Meier note, the drug is toxic. I believe that the current best evidence indicates that megestrol has no role in the care, palliative or otherwise, of frail older . . . [Full Text of this Article]

Thomas E. Finucane, MD
tfinucan@jhmi.edu
Division of Geriatric Medicine and Gerontology
Johns Hopkins Bayview Medical Center
Baltimore, Md

RELATED LETTERS

Frail Older Adults and Palliative Care

JAMA. ;297():1194-1194.
FULL TEXT  

Frail Older Adults and Palliative Care
and
JAMA. ;297():1194-1194.
FULL TEXT  

Frail Older Adults and Palliative Care--Reply
and
JAMA. ;297():1194-1195.
FULL TEXT  

RELATED ARTICLE

Palliative care for frail older adults: "there are things I can't do anymore that I wish I could . . . ".
and
JAMA. ;296():2245-2253.
FULL TEXT