ArticleBMC palliative care2025
"Is this sedation?" - a Group Delphi process to define cut-off doses and dosing intervals for potentially sedating drugs in palliative care.
Article in BMC palliative care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
3 citing papers in PubMed.
- Clinical decision support for potentially sedating drugs in palliative care: a mixed-methods pilot study.BMC palliative care · 2026Article
- Is Unconsciousness the Intention? Physicians' Perspectives on Palliative Sedation Outside Specialized Palliative Care: A Qualitative Study.Journal of bioethical inquiry · 2026Article
- Correction: "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
Corrections and comments
- Erratum issued
Authors and funding
9 authors.
Funding
Abstract
backgroundIn palliative care, it can be challenging to distinguish between reduced consciousness related to the illness and sedation due to a potentially sedating drug (intended, or unintended). These differentiations are important because unintended sedation requires consideration of alternative treatment options, and intentional sedation demands compliance with guidelines. The aim of the study, which was part of the consortium project iSedPall, was to determine cut-off values for drugs' doses/dosing intervals which are expected to result in defined depth of sedation/continuous effect.
methodsGroup Delphi conducted in Germany with prior online survey. Based on a review of the literature, statements regarding cut-off values for drugs´ doses/dosing intervals which are expected to result in a defined depth of sedation/continuous effect were developed for 11 drugs. Consensus was defined as ≥ 75% agreement. Statements with lower agreement entered the next round of discussion. Between the rounds (5 small groups, 3 - 4 participants each), the results were presented and discussed. If necessary, statements were adapted for the following round. Participating experts were physicians, pharmacists, and nurses experienced in palliative care, mostly with over 10 years of professional experience.
results25/30 invited experts participated in the online survey, 17 in the Group Delphi. 12/33 statements were consented in the survey. The initial questionnaire for the Group Delphi comprised 22 statements on ten drugs. After three rounds, consensus was reached for all statements, determining cut-off doses/dosing intervals for lorazepam, midazolam, diazepam, levomepromazine, haloperidol, melperone, pipamperone, propofol, dexmedetomidine, and trazodone.
conclusionsThis study for the first time provides evidence- and expert consensus-based data to support clinical judgements regarding sedating effects of a range of potentially sedating drugs commonly used in palliative care.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.