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The EAPC framework on palliative sedation and clinical practice--a questionnaire-based survey in Germany.

Klosa, Philipp R; Klein, Carsten; Heckel, Maria; Bronnhuber, Alexandra C; Ostgathe, Christoph; Stiel, Stephanie.
Support Care Cancer; 22(10): 2621-8, 2014 Oct.
Artigo em Inglês | MEDLINE | Abr 2014 | ID: mdl-24743852
Resumo: BACKGROUND: Palliative sedation (PS) can be offered to patients with intolerable symptom burden refractory to comprehensive palliative care (PC) treatment. Little is known about the daily practice of using PS in German specialized PC institutions in the context of existing national and international recommendations. PURPOSE: This study's primary objective is to explore how PS is used in German specialized PC institutions with reference to the EAPC framework. METHODS: The heads of all palliative care units, hospices, specialized palliative home care teams, and specialized pediatric palliative home care teams listed in the official address registers were invited to take part in a questionnaire survey about the clinical practice of PS in their institution. RESULTS: Considerable differences of the frequency of PS exist between institutions. The estimated frequency of PS ranges from 0 to 80 % of all patients treated per year (mean 6.7 %). Some PC specialists report to discuss PS as treatment option for every patient they encounter. Specific evaluation and documentation tools are rare. Of the study participants, 36.2 % are not familiar with international and national recommendations. CONCLUSION: Many differences exist in frequency and clinical handling of PS in Germany. Implementation of international and national recommendations into clinical practice remains inconsistent.