'Palliative sedation'? A retrospective cohort study on the use and labelling of continuously administered sedatives on a palliative care unit.

Abstract:

BACKGROUND:Sedatives are frequently used towards the end of life. However, there is scarce information when their use is labelled as 'palliative sedation'. AIM:To assess the use and labelling of 'continuous administration of sedatives within the last 7 days of life', based on objective operational criteria, on a palliative care unit. DESIGN:Retrospective cohort study, using medical records. Explorative statistical analysis (SPSS 23). SETTING/PARTICIPANTS:Patients who died on a palliative care unit from August 2014 to July 2015. Sedatives recorded were benzodiazepines, levomepromazine, haloperidol ⩾5 mg/day and propofol. RESULTS:Of the 192 patients, 149 (78%) patients received continuous sedatives within the last week of life. The prevalence of delirium/agitation was significantly higher in patients with continuous sedatives compared to those without continuous sedatives at admission to the unit (35% vs 16%, p = 0.02) and on the day before death (58% vs 40%, p = 0.04). The term '(palliative) sedation' was used in the records for 22 of 149 (15%) patients with continuous sedatives. These patients had significantly higher total daily midazolam doses 2 days before death (median (range), 15.0 (6.0-185.0) mg vs 11.5 (1.0-70.0) mg, p = 0.04) and on the day of death (median (range), 19.5 (7.5-240.0) mg vs 12.5 (2.0-65.0) mg, p = 0.01). The dose range was large in both groups. CONCLUSION:The prevalence of delirium/agitation was associated with the administration of continuous sedatives. There was no consistent pattern regarding labelling the use of continuous sedatives as '(palliative) sedation'. Multicentre mixed-methods research is needed for a better characterization of sedation practices in palliative care.

journal_name

Palliat Med

journal_title

Palliative medicine

authors

Schildmann E,Pörnbacher S,Kalies H,Bausewein C

doi

10.1177/0269216318764095

subject

Has Abstract

pub_date

2018-07-01 00:00:00

pages

1189-1197

issue

7

eissn

0269-2163

issn

1477-030X

journal_volume

32

pub_type

杂志文章
  • Factors influencing constipation in advanced cancer patients: a prospective study of opioid dose, dantron dose and physical functioning.

    abstract::The relationship between opioid dose, dantron dose, bowel function and physical functioning (measured with the modified Barthel Index) was determined in a sample of 50 inpatients with advanced cancer. Data were collected prospectively from chart review and patient interviews one week after admission to allow for proto...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1191/0269216303pm773oa

    authors: Bennett M,Cresswell H

    更新日期:2003-07-01 00:00:00

  • Chronically homeless persons' participation in an advance directive intervention: A cohort study.

    abstract:BACKGROUND:Chronically homeless individuals have high rates of hospitalization and death, and they may benefit from the completion of advance directives. AIM:To determine the rate of advance directive completion using a counselor-guided intervention, identify characteristics associated with advance directive completio...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1177/0269216315575679

    authors: Leung AK,Nayyar D,Sachdeva M,Song J,Hwang SW

    更新日期:2015-09-01 00:00:00

  • Delivering research in end-of-life care: problems, pitfalls and future priorities.

    abstract::In this paper we review the challenges facing the delivery of research in end-of-life care in the UK and internationally as health policies begin to focus on improving care. These include the problems of terminology in this field of enquiry and the lack of emphasis on clinical studies relating to the medical aspects o...

    journal_title:Palliative medicine

    pub_type: 杂志文章,评审

    doi:10.1177/0269216310366064

    authors: Bennett MI,Davies EA,Higginson IJ

    更新日期:2010-07-01 00:00:00

  • 'Was it worth it?' Intrathecal analgesia for cancer pain: A qualitative study exploring the views of family carers.

    abstract:BACKGROUND:Intrathecal drug delivery is known to reduce pain in patients where conventional systemic analgesia has been ineffective or intolerable. However, there is little information regarding the effects of intrathecal drug delivery on quality of life and function in those with advanced, incurable cancer. AIM:Retro...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1177/0269216317723777

    authors: Patel N,Huddart M,Makins H,Mitchell T,Gibbins JL,Graterol J,Stevens D,Perkins P

    更新日期:2018-01-01 00:00:00

  • A review of dysphagia in four cases of motor neurone disease.

    abstract::Dysphagia is a common and distressing problem in motor neurone disease. This paper examines some of the strategies available for managing patients with dysphagia, and illustrates these with four contrasting case histories. The factors which influence the decision making process in patients with dysphagia are also disc...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1177/0269216393007004S08

    authors: Scott A,Heughan A

    更新日期:1993-01-01 00:00:00

  • Shared decision-making in palliative care: a systematic mixed studies review using narrative synthesis.

    abstract::The aim of this study is to synthesize knowledge about the process of shared decision-making (SDM) in palliative care. Medline, EMBASE, CINAHL, PsychInfo, Web of Science were searched with core concepts: shared decisions, patient participation in decision-making, and palliative care. Titles and abstracts were screened...

    journal_title:Palliative medicine

    pub_type: 杂志文章,评审

    doi:10.1177/0269216310389348

    authors: Bélanger E,Rodríguez C,Groleau D

    更新日期:2011-04-01 00:00:00

  • Existential issues do not necessarily result in existential suffering: lessons from cancer patients in Israel.

    abstract::Existential distress has been recognized as a source of suffering for oncology patients. This study focusses on existential issues and coping mechanisms of a unique culturally diverse Jewish/Middle Eastern oncology population. A qualitative assessment of 40 patients with advanced cancer was undertaken through an inter...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1191/0269216305pm1038oa

    authors: Blinderman CD,Cherny NI

    更新日期:2005-07-01 00:00:00

  • Methodological challenges in researching psychological distress and psychiatric morbidity among patients with advanced cancer: what does the literature (not) tell us?

    abstract::Patients with advanced cancer experience multiple demands and losses that place them at risk for experiencing psychological distress. Researchers can face challenges in conducting research among this population because of their poor levels of physical and cognitive functioning. This paper aims to develop our understan...

    journal_title:Palliative medicine

    pub_type: 杂志文章,评审

    doi:10.1177/0269216311399663

    authors: Ryan D,Gallagher P,Wright S,Cassidy E

    更新日期:2012-03-01 00:00:00

  • Development of a Carer Support Needs Assessment Tool (CSNAT) for end-of-life care practice at home: a qualitative study.

    abstract:BACKGROUND:Current end-of-life care policy and guidance recognises the important contribution of family carers, recommending that their needs should be assessed to support them in their caring role. How regular carer assessment is to be achieved is unclear, particularly because there is no evidence-based tool for direc...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1177/0269216312440607

    authors: Ewing G,Grande G,National Association for Hospice at Home.

    更新日期:2013-03-01 00:00:00

  • Clinical research in palliative care: choice of trial design.

    abstract::Prospective controlled clinical trials provide the highest level of evidence in palliative care. Both parallel and crossover studies have unique advantages and disadvantages. Excellent knowledge of the patient population, interventions and endpoints are useful in choosing the most appropriate trial. Open pilot studies...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1191/026921601678576275

    authors: Mazzocato C,Sweeney C,Bruera E

    更新日期:2001-05-01 00:00:00

  • Survey of specialist palliative care services for noncancer patients in Ireland and perceived barriers.

    abstract:BACKGROUND:Specialist palliative care (SPC) services in Ireland are well developed by international standards. However, standardized information on all patients of SPC services is not collected so the proportion of patients seen with a noncancer diagnosis is just an estimate at 5%. AIMS:To describe Irish SPC services'...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1177/0269216307084609

    authors: O'Leary N,Tiernan E

    更新日期:2008-01-01 00:00:00

  • Hospital doctors' understanding of use and withdrawal of the Liverpool Care Pathway: A qualitative study of practice-based experiences during times of change.

    abstract:BACKGROUND:The Liverpool Care Pathway was used in UK hospitals (late 1990s to July 2014) in an attempt to generate hospice-style high-quality end-of-life care in acute settings. Despite being widely established, there was limited research or contextual evidence regarding this approach or its impact. Growing criticism f...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1177/0269216316679927

    authors: Twigger S,Yardley SJ

    更新日期:2017-10-01 00:00:00

  • Influences on the decision to prescribe or administer anticholinergic drugs to treat death rattle: a focus group study.

    abstract:BACKGROUND:The evidence supporting pharmacological treatment of death rattle is poor; yet, anticholinergic drugs feature in end-of-life care pathways and guidelines worldwide as a treatment option. AIM:This qualitative arm of a wider study aimed to explore important issues which health-care professionals associated wi...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1177/0269216312464407

    authors: Hirsch CA,Marriott JF,Faull CM

    更新日期:2013-09-01 00:00:00

  • Social-cultural factors in end-of-life care in Belgium: a scoping of the research literature.

    abstract:BACKGROUND:As end-of-life (EoL) care expands across Europe and the world, service developments are increasingly studied. The sociocultural context in which such changes take place, however, is often neglected in research. AIM:To explore sociocultural factors in EoL care in Belgium as represented by the literature. DE...

    journal_title:Palliative medicine

    pub_type: 杂志文章,meta分析,评审

    doi:10.1177/0269216311429619

    authors: Andrew EV,Cohen J,Evans N,Meñaca A,Harding R,Higginson I,Pool R,Gysels M,PRISMA.

    更新日期:2013-02-01 00:00:00

  • How hospice staff members prepare family caregivers for the patient's final days of life: an exploratory study.

    abstract:BACKGROUND:There is widespread agreement that the families of hospice patients need to be prepared for the final days of life, yet current practices preparing families are not well described. Examining the gap between family needs and current practice will inform the development of effective preparatory interventions. ...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1177/0269216314551320

    authors: Kehl KA

    更新日期:2015-02-01 00:00:00

  • Home care of a child dying of a malignancy and parental awareness of a child's impending death.

    abstract::In this population-based study, we found that parents who are aware that their child will die from a malignancy are more likely to care for their child at home during the child's last month of life compared to parents who are not aware. End-of-life home care was comparable to hospital care for satisfactory pain relief...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1191/0269216306pm1139oa

    authors: Surkan PJ,Dickman PW,Steineck G,Onelöv E,Kreicbergs U

    更新日期:2006-04-01 00:00:00

  • Which patients with terminal cancer are admitted from home care?

    abstract::The factors related to admission of patients with terminal cancer who had been referred to a reputable home care service were examined in 415 patients referred in a two-year period and in a prospective study of a randomized one in three sample of the 232 adults still alive one week after referral, who were able to con...

    journal_title:Palliative medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1177/026921639400800303

    authors: Hinton J

    更新日期:1994-01-01 00:00:00

  • Advance Care Planning in palliative care: a qualitative investigation into the perspective of Paediatric Intensive Care Unit staff.

    abstract:BACKGROUND:The majority of children and young people who die in the United Kingdom have pre-existing life-limiting illness. Currently, most such deaths occur in hospital, most frequently within the intensive care environment. AIM:To explore the experiences of senior medical and nursing staff regarding the challenges a...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1177/0269216315573000

    authors: Mitchell S,Dale J

    更新日期:2015-04-01 00:00:00

  • Patients' experiences of a new integrated breathlessness support service for patients with refractory breathlessness: Results of a postal survey.

    abstract:BACKGROUND:We developed a new single point of access to integrated palliative care, respiratory medicine and physiotherapy: the breathlessness support service for patients with advanced disease and refractory breathlessness. This study aimed to describe patients' experiences of the service and identify the aspects valu...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1177/0269216315600103

    authors: Reilly CC,Bausewein C,Pannell C,Moxham J,Jolley CJ,Higginson IJ

    更新日期:2016-03-01 00:00:00

  • The impacts and effectiveness of support for people bereaved through advanced illness: A systematic review and thematic synthesis.

    abstract:BACKGROUND:Bereavement support is a key component of palliative care, with different types of support recommended according to need. Previous reviews have typically focused on specialised interventions and have not considered more generic forms of support, drawing on different research methodologies. AIM:To review the...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1177/0269216320920533

    authors: Harrop E,Morgan F,Longo M,Semedo L,Fitzgibbon J,Pickett S,Scott H,Seddon K,Sivell S,Nelson A,Byrne A

    更新日期:2020-07-01 00:00:00

  • Preference for place of care and place of death in palliative care: are these different questions?

    abstract::Place of death is at times suggested as an outcome for palliative care services. This study aimed to describe longitudinal preferences for place of care and place of death over time for patients and their caregivers. Longitudinal paired data of patient/caregiver dyads from a prospective unblinded cluster randomised co...

    journal_title:Palliative medicine

    pub_type: 杂志文章,随机对照试验

    doi:10.1177/0269216308092287

    authors: Agar M,Currow DC,Shelby-James TM,Plummer J,Sanderson C,Abernethy AP

    更新日期:2008-10-01 00:00:00

  • Systematic review of bisphosphonates for hypercalcaemia of malignancy.

    abstract:BACKGROUND:Bisphosphonates are the treatment of choice for hypercalcaemia of malignancy (HCM) but there is no consensus regarding which drug or dose should be given. We designed a systematic review to investigate the efficacy of bisphosphonates in the treatment of HCM. METHODS:We identified randomized controlled trial...

    journal_title:Palliative medicine

    pub_type: 杂志文章,评审

    doi:10.1191/0269216304pm914ra

    authors: Saunders Y,Ross JR,Broadley KE,Edmonds PM,Patel S,Steering Group.

    更新日期:2004-07-01 00:00:00

  • The challenges of uncertainty and interprofessional collaboration in palliative care for non-cancer patients in the community: a systematic review of views from patients, carers and health-care professionals.

    abstract:BACKGROUND:Primary care has the potential to play significant roles in providing effective palliative care for non-cancer patients. AIM:To identify, critically appraise and synthesise the existing evidence on views on the provision of palliative care for non-cancer patients by primary care providers and reveal any gap...

    journal_title:Palliative medicine

    pub_type: 杂志文章,评审

    doi:10.1177/0269216314531999

    authors: Oishi A,Murtagh FE

    更新日期:2014-10-01 00:00:00

  • Legacy perceptions and interventions for adults and children receiving palliative care: A systematic review.

    abstract:BACKGROUND:Legacy has been invoked as a means for strengthening human attachments, continuing bonds, and ensuring that individuals will be remembered; however, little is known about the spectrum of approaches to, outcomes associated with, and best practices for legacy interventions. AIM:To systematically review resear...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1177/0269216321989565

    authors: Boles JC,Jones MT

    更新日期:2021-01-25 00:00:00

  • Does being religious help or hinder coping with chronic illness? A critical literature review.

    abstract::This paper reviews a number of studies relating to religion and coping with chronic illness, emphasizing those aspects relevant to palliative care. After pointing out that religious and existential needs are common in chronic illness, a critical examination is made of those studies which purport to demonstrate associa...

    journal_title:Palliative medicine

    pub_type: 杂志文章,评审

    doi:10.1177/026921639701100405

    authors: Dein S,Stygall J

    更新日期:1997-07-01 00:00:00

  • The role of general practitioners in continuity of care at the end of life: a qualitative study of terminally ill patients and their next of kin.

    abstract:OBJECTIVES:Exploring terminal patients' perceptions of GPs' role in delivering continuous end-of-life care and identifying barriers to this. DESIGN:Qualitative interview study with patients (two consecutive interviews). SETTING:Primary care Belgium. PARTICIPANTS:Seventeen terminally ill cancer patients, informed abo...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1177/0269216307078503

    authors: Michiels E,Deschepper R,Van Der Kelen G,Bernheim JL,Mortier F,Vander Stichele R,Deliens L

    更新日期:2007-07-01 00:00:00

  • Inappropriateness of using opioids for end-stage palliative sedation: a Dutch study.

    abstract::To be able to distinguish end-stage palliative sedation from euthanasia without having to refer to intentions that are difficult to verify, physicians must be able to manage palliative sedation appropriately (i.e., see that death is not hastened as a result of disproportionate medication). In the present study, we ass...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1177/0269216308091867

    authors: Reuzel RP,Hasselaar GJ,Vissers KC,van der Wilt GJ,Groenewoud JM,Crul BJ

    更新日期:2008-07-01 00:00:00

  • Understanding what works, why and in what circumstances in hospice at home services for end-of-life care: Applying a realist logic of analysis to a systematically searched literature review.

    abstract:BACKGROUND:We have undertaken a systematically searched literature review using a realist logic of analysis to help synthesise the diverse range of literature available on hospice at home services. AIM:To find out in the existing literature what features of hospice at home models work best, for whom and under what cir...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1177/0269216319867424

    authors: Hashem F,Brigden C,Wilson P,Butler C

    更新日期:2020-01-01 00:00:00

  • Attitudes of Danish doctors and nurses to palliative and terminal care.

    abstract:BACKGROUND:The WHO definitions of palliative care have been adopted in Denmark and implemented in The National Guidelines from 1999, but service developments have been very slow and not according to the recommendations. Attitudes to palliative care of Danish doctors and nurses may in part account for this. OBJECTIVE:T...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1191/0269216305pm988oa

    authors: Vejlgaard T,Addington-Hall JM

    更新日期:2005-03-01 00:00:00

  • Home or hospital as the place of end-of-life care and death: A grounded theory study of parents' decision-making.

    abstract:BACKGROUND:While several studies have examined 'what' families want with regard to the place of a child's end-of-life care and death, few have explored 'how' parents reach a decision. AIMS:(1) to develop a model explaining how parents of a child with a life-threatening illness in Greece decide about the place of end-o...

    journal_title:Palliative medicine

    pub_type: 杂志文章

    doi:10.1177/0269216320967547

    authors: Papadatou D,Kalliani V,Karakosta E,Liakopoulou P,Bluebond-Langner M

    更新日期:2021-01-01 00:00:00