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Medically assisted hydration for adults receiving palliative care
Emma J Buchan1, Alison Haywood2,3, William Syrmis4
1Queensland Health, Brisbane, Australia.
The Cochrane Database of Systematic Reviews
|December 14, 2023
Summary
Medically assisted hydration (MAH) offers no proven benefits for quality of life or survival in palliative care patients. More research is needed to determine the effectiveness and safety of MAH in this population.
Area of Science:
- Palliative Care
- Clinical Effectiveness Research
- Fluid Management
Background:
- Reduced oral intake is common in palliative care, particularly at end-of-life.
- Medically assisted hydration (MAH) is used to potentially improve quality of life (QoL) and prolong survival.
- This review is an update of previous Cochrane Reviews from 2008, 2011, and 2014.
Approach:
- Systematic review of randomized controlled trials (RCTs) comparing MAH to placebo or standard care.
- Searched multiple databases including CENTRAL, MEDLINE, and Embase up to November 2022.
- Assessed QoL, survival, and adverse events using GRADE criteria.
Key Points:
- Four studies (422 participants) with advanced cancer were included; most were solid organ malignancies.
- Evidence is insufficient to determine if MAH improves QoL or survival compared to placebo.
- Evidence is insufficient to determine if MAH improves survival compared to standard care, with potential for increased adverse events.
Conclusions:
- There is insufficient evidence to support the use of MAH for improving QoL or survival in palliative care.
- Findings are limited to inpatient advanced cancer patients and not generalizable to other settings or conditions.
- Clinical decisions regarding MAH should be individualized based on perceived benefits and harms.
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