Palliative sedation in advanced cancer patients followed at home: a retrospective analysis.

Alessandra Casuccio, Claudio Adile, Sebastiano Mercadante, Giampiero Porzio, Alessandro Valle, Flavio Fusco, Federica Aielli

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26 Citations (Scopus)

Abstract

AbstractCONTEXT: Data regarding palliative sedation at home in dying patients are lacking.OBJECTIVES: To describe the frequency, indication, and modality of palliative sedation (PS) in patients followed at home.METHODS: A retrospective analysis of home care cancer patients was performed. Patients who received PS before dying were selected and information about epidemiologic characteristics, indications, duration, drugs, and outcomes was collected.RESULTS: Of 370 medical charts of patients who died at home, 49 patients received PS before dying. PS was proposed by the team, relatives, or both in 63.3%, 4.1%, and 32.6% of cases, respectively. Delirium alone or in combination with other symptoms was the most frequent indication to begin PS. Midazolam was the most frequently used drug to initiate PS (98%), at a mean dose of 28.1 mg/day, in combination with parenteral morphine (84.7%) at a mean dose of 25.4 mg/day. At the time of death, midazolam was administered in 98% of patients (mean dose 22.3 mg/day), combined with parenteral morphine in 87.8% of patients (mean dose 28.1 mg/day). Satisfaction for physicians and principal caregivers after PS was good in 46 and 48 cases, respectively.CONCLUSION: PS at home seems to be a feasible treatment option among selected patients and makes a potentially important contribution to improving care for those who choose to die at home.
Original languageEnglish
Pages (from-to)1126-1130
Number of pages5
JournalJournal of Pain and Symptom Management
Volume43
Publication statusPublished - 2012

All Science Journal Classification (ASJC) codes

  • Nursing(all)
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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    Casuccio, A., Adile, C., Mercadante, S., Porzio, G., Valle, A., Fusco, F., & Aielli, F. (2012). Palliative sedation in advanced cancer patients followed at home: a retrospective analysis. Journal of Pain and Symptom Management, 43, 1126-1130.