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

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Abstract

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.

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Acknowledgments

This study received a grant from the “Erlanger Leistungsbezogene Anschubfinanzierung und Nachwuchsförderung” (ELAN), a local fund to support research and education at the Friedrich-Alexander-Universität Erlangen-Nürnberg. We thank all participants for answering the questionnaire and all colleagues for providing insight into their questionnaires used in the PS research.

Conflict of interest statement

The authors declare that there is no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Palliative Medicine, Comprehensive Cancer Center, CCC Erlangen—EMN, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Krankenhausstraße 12, 91054, Erlangen, Germany

    Philipp R. Klosa, Carsten Klein, Maria Heckel, Alexandra C. Bronnhuber, Christoph Ostgathe & Stephanie Stiel

Authors
  1. Philipp R. Klosa
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  2. Carsten Klein
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  3. Maria Heckel
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  4. Alexandra C. Bronnhuber
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  5. Christoph Ostgathe
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  6. Stephanie Stiel
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Corresponding author

Correspondence to Carsten Klein.

Additional information

The present work was performed in fulfillment of the requirements for obtaining the doctoral title “Dr. med.” of the first author.

Philipp R. Klosa and Carsten Klein contributed equally to this manuscript.

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Klosa, P.R., Klein, C., Heckel, M. et al. The EAPC framework on palliative sedation and clinical practice—a questionnaire-based survey in Germany. Support Care Cancer 22, 2621–2628 (2014). https://doi.org/10.1007/s00520-014-2192-5

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  • DOI: https://doi.org/10.1007/s00520-014-2192-5

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