374 Vol. 43 No. 2 February 2012Schedule With Abstracts

no religious affiliation, 83% described them-selves as spiritual but not religious, 33% re-ported unmet spiritual needs, and 60%wanted help meeting their spiritual needs.The Cronbach’s a for the total SNAP was 0.89and for the subscales was: psychosocial ¼ 0.58,spiritual ¼ 0.83, and religious needs ¼ 0.90.Test-retest correlation coefficients were: totalSNAP ¼ 0.72, psychosocial needs ¼ 0.43, spiri-tual needs ¼ 0.73, and religious needs ¼ 0.72.Unmet spiritual needs, as assessed through a sin-gle-item question were not associated with high-er SNAP scores in contrast to results of theEnglish SNAP.

Conclusion. The Chinese SNAP is a reliable in-strument for measuring spiritual needs.

Implications for research, policy, or practice.Lack of correlation between the SNAP and thesingle-item question on unmet spiritual needssuggests that the SNAP may capture patientneeds that Chinese patients would not readilydescribe as spiritual whether due to cultural dif-ferences or educational level.

Benzodiazepines and the Management ofDyspnea in Palliative Care Patients (411-A)Patama Gomutbutra, MD, University ofCaliforniaSan Francisco, San Francisco, CA. DavodO’Riordan, PhD, University of California SanFrancisco, San Francisco, CA. Kathleen Kerr, BA,University of California San Francisco, San Fran-cisco, CA. Stevem Pantilat, MD, University of Cal-ifornia San Francisco, San Francisco, CA.(All authors listed above for this session have dis-closed no relevant financial relationships.)

Objectives1. Describe of the impact of BZD in improving

dyspnea of chronically ill patients.2. Describe dyspnea management in palliative

care setting.

Background. Benzodiazepines (BZD) are com-monly prescribed for relief of dyspnea, yet thereis little evidence describing the efficacy of thetreatment of dyspnea in chronically ill patients.

Research objective. To describe the impact ofBZD in improving dyspnea of chronically illpatients.

Method. A retrospective chart review was under-taken of adults with dyspnea seen by the UCSFPalliative Care Service (PCS) during 2005-2010.Dyspnea was assessed using a four-point

categorical scale (0 ¼ none, 1 ¼ mild, 3 ¼ mod-erate, 4 ¼ severe).

Result. We reviewed charts for 93.6% (308/330)of eligible cases. Patients were 66 years old, male(52%), white (52%), and diagnosed with lungcancer (40%), heart failure ([HF]¼24%), orCOPD (19%). At baseline, most patients had ei-ther mild (53%), moderate (28%), or severe(19%) dyspnea. BZD were prescribed to 37%(n ¼ 113) of patients, with 66% (n ¼ 75) receiv-ing BZD in the first 24 hours of being referred tothe PCS. In multivariate logistic regression, vari-ables associated with receiving BDZ includedconcurrent opioid use (OR ¼ 4.8, 95% CI ¼2.2, 10.3), gender (female: OR ¼ 1.7, 95%CI ¼ 1.1, 3.3), and age (OR ¼ 0.9, 95% CI ¼0.96, 0.99). Overall 56% (n ¼ 172) had a clini-cally meaningful improvement (1-point) in dysp-nea at 24 hours, 38% (n ¼ 117) had noimprovement, and 7% (n ¼ 20) got worse. Amultivariate logistic regression indentified thatthe strongest predictors of a clinically meaning-ful improvement in dyspnea were age (OR ¼1.02, 95% CI ¼ 1.0, 1.03), and being prescribedBDZ (2.3, 95% CI ¼ 1.2, 4.2).

Conclusion. BZD were associated with improve-ments in dyspnea among patients seen in a PCS.

Implications for research, policy, or practice.BZD maybe an appropriate adjuvant treatmentfor dyspnea.

Rapid Treatments for Depression andAnxiety (411-B)Scott Irwin, MD PhD, The Institute for PalliativeMedicine at San Diego Hospice, San Diego, CA.(Irwin has disclosed no relevant financialrelationships.)

Objectives1. Recognize the significance of depression

near the end of life.2. Recognize new data suggesting ketamine and

methylphenidate may rapidly ameliorate de-pression in patients receiving hospice care.

3. Discuss further investigation of ketamine andmethylphenidate for the rapid treatment ofdepression in medically ill patients.

Background. Depression is prevalent and under-treated in patients receiving hospice care. Stan-dard antidepressants do not work rapidly oroften enough to benefit most of these patients.Ketamine and methylphenidate may provide via-ble alternatives in this population.