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Palliative sedation in Germany: how much do we know? A prospective survey
Birgit Jaspers1, Friedemann Nauck, Gabriele Lindena
1Department of Palliative Medicine, University of Bonn, Germany.
Journal of Palliative Medicine
|June 5, 2012
Summary
Palliative sedation (PS) was used in 13% of palliative care units and 25% of hospices in Germany. Midazolam was the most common medication, with dyspnea and pain being primary reasons for PS in palliative care units.
Area of Science:
- Palliative Care Medicine
- Medical Ethics
- Health Services Research
Background:
- Limited data exists on palliative sedation (PS) practices in Germany.
- This study analyzes sedation data from the German HOPE palliative care documentation system.
Purpose of the Study:
- To investigate the prevalence and practice of palliative sedation in German palliative care units (PCUs) and hospices (H).
- To identify reasons for and characteristics of palliative sedation use.
Main Methods:
- Analysis of data from 1,944 patients collected via the HOPE system and its optional ethical decision-making module (2005-2006).
- Descriptive analysis of data from representative PCUs and a non-representative hospice control group.
- Chi-squared tests were used to compare data, and free-text entries were inductively categorized.
Main Results:
- Palliative sedation (PS) was administered to 13.0% (2005) and 11.8% (2006) of patients in PCUs, and 25.5% (2005) and 22.9% (2006) in hospices.
- Primary reasons for PS in PCUs included dyspnea, pain, and anxiety; hospices showed more varied, often psychosocial, reasons.
- Midazolam was the most frequently used medication; sedated patients were younger than non-sedated patients.
Conclusions:
- This study provides initial insights into palliative sedation use in German PCUs and hospices.
- A new optional module for PS is under development to facilitate more detailed systematic surveys on decision-making and procedures.
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