ArticleBMC palliative care2023
Expert-approved best practice recommendations on the use of sedative drugs and intentional sedation in specialist palliative care (SedPall).
Article in BMC palliative care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Clinical decision support for potentially sedating drugs in palliative care: a mixed-methods pilot study.BMC palliative care · 2026Article
- Evolution of Hemophilia Management in Italy: Results from a Delphi Consensus Study.Journal of clinical medicine · 2026Article
- A complex intervention to support the use of sedative drugs in specialist palliative care: results from the iSedPall pilot study.BMC palliative care · 2026Article
- The decision-making process for sedation in specialist palliative care: a qualitative interview study with team members, relatives, and patients.BMC palliative care · 2026Article
- Participatory development of patient-targeted guideline material in palliative care: A qualitative evaluation.Palliative care and social practice · 2026Article
- Community engagement in health guidelines and other normative products: a methodological review.Bulletin of the World Health Organization · 2025Review
- "Is this sedation?" - a Group Delphi process to define cut-off doses and dosing intervals for potentially sedating drugs in palliative care.BMC palliative care · 2025Article
- Evaluating physicians' knowledge of assisted suicide and palliative sedation therapy in Austria : An exploratory survey study.Wiener klinische Wochenschrift · 2025Article
- Off-label drug use in palliative medicine: Delphi study for the consensus of evidence-based treatment recommendations.Palliative medicine · 2025Article
- Use of sedative drugs in specialist palliative care (iSedPall): a multi-modal intervention pilot study protocol.Pilot and feasibility studies · 2025Article
- Palliative use of midazolam in acute geriatric units: a multicenter ambispective study.BMC geriatrics · 2025Article
- An easier way to die?-A qualitative interview study on specialist palliative care team members' views on dying under sedation.Palliative medicine · 2025Article
- Continuous Sedation in Palliative Care in Portugal: A Prospective Multicentric Study.Journal of palliative care · 2025Article
- Observational
- [New recommendations on palliative sedation].Schmerz (Berlin, Germany) · 2024Article
- Development of a Complex Intervention to Support the Use of Sedative Drugs in Specialist Palliative Care (iSedPall).Palliative medicine reports · 2024Article
Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
backgroundThe use of sedative drugs and intentional sedation in end-of-life care is associated with clinical, ethical and legal challenges. In view of these and of the issue's great importance to patients undergoing intolerable suffering, we conducted a project titled SedPall ("From anxiolysis to deep continuous sedation - Development of recommendations for sedation in palliative care") with the purpose of developing best practice recommendations on the use of sedative drugs and intentional sedation in specialist palliative care and obtaining feedback and approval from experts in this area.
designOur stepwise approach entailed drafting the recommendations, obtaining expert feedback, conducting a single-round Delphi study, and convening a consensus conference. As an interdisciplinary group, we created a set of best practice recommendations based on previously published guidance and empirical and normative analysis, and drawing on feedback from experts, including patient representatives and of public involvement participants. We set the required agreement rate for approval at the single-round Delphi and the consensus conference at ≥80%.
resultsTen experts commented on the recommendations' first draft. The Delphi panel comprised 50 experts and patient and public involvement participants, while 46 participants attended the consensus conference. In total, the participants in these stages of the process approved 66 recommendations, covering the topics "indications", "intent/purpose [of sedation]", "decision-making", "information and consent", "medication and type of sedation", "monitoring", "management of fluids and nutrition", "continuing other measures", "support for relatives", and "team support". The recommendations include suggestions on terminology and comments on legal issues.
conclusionFurther research will be required for evaluating the feasibility of the recommendations' implementation and their effectiveness. The recommendations and the suggested terminology may serve as a resource for healthcare professionals in Germany on the use of sedative drugs and intentional sedation in specialist palliative care and may contribute to discussion on the topic at an international level.
trial registrationDRKS00015047 (German Clinical Trials Register).
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