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

Area of Science:

• Palliative Care
• Medical Ethics
• Clinical Practice Guidelines

Background:

• Palliative sedation (PS) is an option for patients with refractory symptoms despite comprehensive palliative care (PC).
• Current understanding of daily PS practice in German specialized PC institutions is limited, especially regarding adherence to recommendations.

Purpose of the Study:

• To investigate the utilization of palliative sedation in German specialized PC institutions.
• To assess the alignment of PS practices with the European Association for Palliative Care (EAPC) framework.

Main Methods:

• A questionnaire survey was distributed to heads of various German specialized PC institutions.
• The survey focused on the clinical practice of palliative sedation within these institutions.

Main Results:

• Significant institutional variation in the frequency of PS use was observed, ranging from 0% to 80% (mean 6.7%).
• Many PC specialists do not utilize specific evaluation or documentation tools for PS.
• A notable percentage (36.2%) of participants were unfamiliar with existing international and national PS recommendations.

Conclusions:

• There are substantial discrepancies in the frequency and clinical management of PS across Germany.
• The integration of international and national recommendations into clinical practice for PS remains inconsistent.