6533b826fe1ef96bd1285387
RESEARCH PRODUCT
Palliative Sedation in Patients With Advanced Cancer Followed at Home: A Prospective Study
Giampiero PorzioCasuccio AlessandraAlessandro ValleSebastiano MercadanteFederica Aiellisubject
AdultMaleend of lifemedicine.medical_specialtyPalliative careContext (language use)Settore MED/42 - Igiene Generale E ApplicataPalliative sedationend of life; midazolam; palliative care; Palliative sedation; Adult; Aged; Aged 80 and over; Delirium; Dyspnea; Family; Feasibility Studies; Female; Humans; Hypnotics and Sedatives; Italy; Male; Midazolam; Middle Aged; Neoplasms; Palliative Care; Patient Care Team; Prospective Studies; Terminal Care; Young Adult; Home Care Services; Anesthesiology and Pain Medicine; Neurology (clinical); Nursing (all)2901 Nursing (miscellaneous); Medicine (all)Young AdultPalliative sedationNeoplasms80 and overmedicineHumansHypnotics and SedativesFamilyIn patientProspective StudiesIntensive care medicineProspective cohort studyNursing (all)2901 Nursing (miscellaneous)General NursingAgedAged 80 and overPatient Care TeamTerminal Carepalliative carebusiness.industryMedicine (all)DeliriumMiddle AgedHome Care ServicesAdvanced cancerDistressDyspneaAnesthesiology and Pain MedicinePalliative sedation; end of life; midazolam; palliative careItalymidazolamEmergency medicineFeasibility StudiesMidazolamFemaleNeurology (clinical)businessmedicine.drugdescription
Abstract Context Home care programs in Italy. Objectives The aim of this study was to assess a protocol for palliative sedation (PS) performed at home. Methods A total of 219 patients were prospectively assessed to evaluate a PS protocol in patients with advanced cancer followed at home by two home care programs with different territorial facilities. The protocol was based on stepwise administration of midazolam. Results A total of 176 of the patients died at home, and PS was performed in 24 of these patients (13.6%). Younger patients received the procedure more frequently than older patients (P = 0.012). The principal reasons to start PS were agitated delirium (n = 20) and dyspnea (n = 4). Mean duration of PS was 42.2 ± 30.4 hours, and the mean doses of midazolam were 23–58 mg/day. Both the home care team and the patients' relatives expressed optimal or good levels of satisfaction with the procedure in all but one case, respectively. Conclusion This protocol for PS was feasible and effective in minimizing distress for a subgroup of patients who died at home. The characteristics of patients who may be effectively sedated at home should be better explored in future studies.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2014-01-01 | Journal of Pain and Symptom Management |