Expert-approved best practice recommendations on the use of sedative drugs and intentional sedation in specialist palliative care (SedPall)
Abstract Background The use of sedative drugs and intentional sedation in end-of-life care is associated with clinical, ethical and legal challenges. In view of these and of the issue’s great importance to patients undergoing intolerable suffering, we conducted a project titled SedPall (“From anxiol...
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | BMC Palliative Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12904-023-01243-z |
| _version_ | 1797555740271968256 |
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| author | Christoph Ostgathe Claudia Bausewein Eva Schildmann Jeremias Bazata Violet Handtke Maria Heckel Carsten Klein Alexander Kremling Sandra Kurkowski Sophie Meesters Andreas Seifert Jorge Luis Torres Cavazos Kerstin Ziegler Christian Jäger Jan Schildmann |
| author_facet | Christoph Ostgathe Claudia Bausewein Eva Schildmann Jeremias Bazata Violet Handtke Maria Heckel Carsten Klein Alexander Kremling Sandra Kurkowski Sophie Meesters Andreas Seifert Jorge Luis Torres Cavazos Kerstin Ziegler Christian Jäger Jan Schildmann |
| author_sort | Christoph Ostgathe |
| collection | DOAJ |
| description | Abstract Background The use of sedative drugs and intentional sedation in end-of-life care is associated with clinical, ethical and legal challenges. In view of these and of the issue’s great importance to patients undergoing intolerable suffering, we conducted a project titled SedPall (“From anxiolysis to deep continuous sedation – Development of recommendations for sedation in palliative care“) with the purpose of developing best practice recommendations on the use of sedative drugs and intentional sedation in specialist palliative care and obtaining feedback and approval from experts in this area. Design Our stepwise approach entailed drafting the recommendations, obtaining expert feedback, conducting a single-round Delphi study, and convening a consensus conference. As an interdisciplinary group, we created a set of best practice recommendations based on previously published guidance and empirical and normative analysis, and drawing on feedback from experts, including patient representatives and of public involvement participants. We set the required agreement rate for approval at the single-round Delphi and the consensus conference at ≥80%. Results Ten experts commented on the recommendations’ first draft. The Delphi panel comprised 50 experts and patient and public involvement participants, while 46 participants attended the consensus conference. In total, the participants in these stages of the process approved 66 recommendations, covering the topics “indications”, “intent/purpose [of sedation]”, “decision-making”, “information and consent”, “medication and type of sedation”, “monitoring”, “management of fluids and nutrition”, “continuing other measures”, “support for relatives”, and “team support”. The recommendations include suggestions on terminology and comments on legal issues. Conclusion Further research will be required for evaluating the feasibility of the recommendations’ implementation and their effectiveness. The recommendations and the suggested terminology may serve as a resource for healthcare professionals in Germany on the use of sedative drugs and intentional sedation in specialist palliative care and may contribute to discussion on the topic at an international level. Trial Registration DRKS00015047 (German Clinical Trials Register) |
| first_indexed | 2024-03-10T16:51:47Z |
| format | Article |
| id | doaj.art-65829823e65a477bb0dae4829665dd17 |
| institution | Directory Open Access Journal |
| issn | 1472-684X |
| language | English |
| last_indexed | 2024-03-10T16:51:47Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Palliative Care |
| spelling | doaj.art-65829823e65a477bb0dae4829665dd172023-11-20T11:17:11ZengBMCBMC Palliative Care1472-684X2023-09-0122111410.1186/s12904-023-01243-zExpert-approved best practice recommendations on the use of sedative drugs and intentional sedation in specialist palliative care (SedPall)Christoph Ostgathe0Claudia Bausewein1Eva Schildmann2Jeremias Bazata3Violet Handtke4Maria Heckel5Carsten Klein6Alexander Kremling7Sandra Kurkowski8Sophie Meesters9Andreas Seifert10Jorge Luis Torres Cavazos11Kerstin Ziegler12Christian Jäger13Jan Schildmann14Department of Palliative Medicine, CCC Erlangen – EMN, Universitätsklinikum Erlangen, Friedrich- Alexander-Universität Erlangen-Nürnberg (FAU)Department of Palliative Medicine, LMU University Hospital, LMU MunichDepartment of Palliative Medicine, LMU University Hospital, LMU MunichDepartment of Palliative Medicine, LMU University Hospital, LMU MunichDepartment of Palliative Medicine, LMU University Hospital, LMU MunichDepartment of Palliative Medicine, CCC Erlangen – EMN, Universitätsklinikum Erlangen, Friedrich- Alexander-Universität Erlangen-Nürnberg (FAU)Department of Palliative Medicine, CCC Erlangen – EMN, Universitätsklinikum Erlangen, Friedrich- Alexander-Universität Erlangen-Nürnberg (FAU)Institute for History and Ethics of Medicine, Interdisciplinary Center for Health Sciences, Martin Luther University Halle-WittenbergDepartment of Palliative Medicine, CCC Erlangen – EMN, Universitätsklinikum Erlangen, Friedrich- Alexander-Universität Erlangen-Nürnberg (FAU)Department of Palliative Medicine, LMU University Hospital, LMU MunichPaderborn Centre for Educational Research and Teacher Education – PLAZ Professional School, Paderborn UniversityDepartment of Palliative Medicine, CCC Erlangen – EMN, Universitätsklinikum Erlangen, Friedrich- Alexander-Universität Erlangen-Nürnberg (FAU)Department of Criminal Law, Criminal Procedural Law, Commercial Criminal Law and Medical Criminal Law, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU)Department of Criminal Law, Criminal Procedural Law, Commercial Criminal Law and Medical Criminal Law, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU)Institute for History and Ethics of Medicine, Interdisciplinary Center for Health Sciences, Martin Luther University Halle-WittenbergAbstract Background The use of sedative drugs and intentional sedation in end-of-life care is associated with clinical, ethical and legal challenges. In view of these and of the issue’s great importance to patients undergoing intolerable suffering, we conducted a project titled SedPall (“From anxiolysis to deep continuous sedation – Development of recommendations for sedation in palliative care“) with the purpose of developing best practice recommendations on the use of sedative drugs and intentional sedation in specialist palliative care and obtaining feedback and approval from experts in this area. Design Our stepwise approach entailed drafting the recommendations, obtaining expert feedback, conducting a single-round Delphi study, and convening a consensus conference. As an interdisciplinary group, we created a set of best practice recommendations based on previously published guidance and empirical and normative analysis, and drawing on feedback from experts, including patient representatives and of public involvement participants. We set the required agreement rate for approval at the single-round Delphi and the consensus conference at ≥80%. Results Ten experts commented on the recommendations’ first draft. The Delphi panel comprised 50 experts and patient and public involvement participants, while 46 participants attended the consensus conference. In total, the participants in these stages of the process approved 66 recommendations, covering the topics “indications”, “intent/purpose [of sedation]”, “decision-making”, “information and consent”, “medication and type of sedation”, “monitoring”, “management of fluids and nutrition”, “continuing other measures”, “support for relatives”, and “team support”. The recommendations include suggestions on terminology and comments on legal issues. Conclusion Further research will be required for evaluating the feasibility of the recommendations’ implementation and their effectiveness. The recommendations and the suggested terminology may serve as a resource for healthcare professionals in Germany on the use of sedative drugs and intentional sedation in specialist palliative care and may contribute to discussion on the topic at an international level. Trial Registration DRKS00015047 (German Clinical Trials Register)https://doi.org/10.1186/s12904-023-01243-zPalliative careTerminal careHypnotics and sedativesPractice guidelinesEmpirical researchCommunity-based participatory research |
| spellingShingle | Christoph Ostgathe Claudia Bausewein Eva Schildmann Jeremias Bazata Violet Handtke Maria Heckel Carsten Klein Alexander Kremling Sandra Kurkowski Sophie Meesters Andreas Seifert Jorge Luis Torres Cavazos Kerstin Ziegler Christian Jäger Jan Schildmann Expert-approved best practice recommendations on the use of sedative drugs and intentional sedation in specialist palliative care (SedPall) BMC Palliative Care Palliative care Terminal care Hypnotics and sedatives Practice guidelines Empirical research Community-based participatory research |
| title | Expert-approved best practice recommendations on the use of sedative drugs and intentional sedation in specialist palliative care (SedPall) |
| title_full | Expert-approved best practice recommendations on the use of sedative drugs and intentional sedation in specialist palliative care (SedPall) |
| title_fullStr | Expert-approved best practice recommendations on the use of sedative drugs and intentional sedation in specialist palliative care (SedPall) |
| title_full_unstemmed | Expert-approved best practice recommendations on the use of sedative drugs and intentional sedation in specialist palliative care (SedPall) |
| title_short | Expert-approved best practice recommendations on the use of sedative drugs and intentional sedation in specialist palliative care (SedPall) |
| title_sort | expert approved best practice recommendations on the use of sedative drugs and intentional sedation in specialist palliative care sedpall |
| topic | Palliative care Terminal care Hypnotics and sedatives Practice guidelines Empirical research Community-based participatory research |
| url | https://doi.org/10.1186/s12904-023-01243-z |
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