Sedation at the end of life outside specialist palliative care - An exploratory mixed methods study on practices and challenges in Germany

• Conditions: Patients dying in settings of general palliative care (general hospital wards, nursing homes)

• Registration Number: DRKS00014574
• Lead Sponsor: Klinik und Poliklinik für Palliativmedizin, Klinikum der Universität München

Brief Summary

The use of sedatives overall and the use of sedatives with a continuous effect was significantly more frequently in hospitals than in nursing homes: 63% of patients received sedatives overall and 50% with a continuous effect in hospitals; in nursing homes, 21% of residents received sedatives overall and 9% with a continuous effect. Midazolam was administered most frequently in hospitals and lorazepam in nursing homes. Around a third of patients/residents were administered sedatives with a continuous effect without documentation of an indication. The age of the patients/residents, the setting, the documentation of the term "palliative" (hospital only) and the inclusion of specialised palliative care (hospital only) were found to be significant influencing factors for the use of sedatives.

Detailed Description

Not available

Study Timeline

• Study Start: 2018-09-26
• Results First Posted: 2019-11-28
• Study Completion: 2021-12-31
• Last Update Posted: 19 August 2024

Recruitment & Eligibility

• Status: Complete
• Sex: All
• Target Recruitment: 1194

Inclusion Criteria

Part I (retrospective case notes review): Adult patients who died in participating centres between 2015 and 2017
Part II: Physicians and nurses working in the participating centres + additional selected physicians and nurses from different hospital departments and general practitioners, who care for patients in nursing homes, from different sites in Germany, who have experience in caring for dying people.

Exclusion Criteria

Part I: < 18 years
Part II: unable to speak sufficient German; < 18 years

Study & Design

• Study Type: observational
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
As this is no intervention study, there are no endpoints.<br>We will assess the frequency and characteristics (medication, documented terminology, decision making) of different types of sedation outside specialist palliative care during the last seven days of life as well as the experiences and challenges regarding different types of sedation as perceived by health care professionals

Secondary Outcome Measures

Name	Time	Method
s. explanation primary timepoint