Continuous Sedation in Palliative Care in Portugal: A Prospective Multicentric Study

Objective: This study aimed to survey the practice of palliative sedation in Portugal, where data on this subject were lacking. Methods: This was a prospective multicentric study that included all patients admitted to each team that agreed to participate. Patients were followed until death, discharg...

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Bibliographic Details
Published in:	Journal of palliative care Vol. 40; no. 1; pp. 72 - 78
Main Authors:	Ferraz-Gonçalves, José António, Flores, Alice, Silva, Ana Abreu, Simões, Ana, Pais, Carmen, Melo, Clarisse, Pirra, Diana, Coelho, Dora, Conde, Lília, Real, Lorena, Feio, Madalena, Barbosa, Manuel, Martins, Maria de Lurdes, Areias, Marlene, Muñoz-Romero, Rafael, Ferreira, Rita Cunha, Freitas, Susete
Format:	Journal Article
Language:	English
Published:	Los Angeles, CA SAGE Publications 01-01-2025 SAGE PUBLICATIONS, INC
Subjects:	Anesthesia Palliative care Practices and Guidelines for Palliative Sedation in Global Contexts Portugal continuous sedation refractory symptoms midazolam palliative sedation delirium
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Summary:	Objective: This study aimed to survey the practice of palliative sedation in Portugal, where data on this subject were lacking. Methods: This was a prospective multicentric study that included all patients admitted to each team that agreed to participate. Patients were followed until death, discharge, or after 3 months of follow-up. Results: The study included 8 teams: 4 as palliative care units (PCU), 1 as a hospital palliative care team (HPCT), 2 as home care (HC), and 1 as HPCT and HC. Of the 361 patients enrolled, 52% were male, the median age was 76 years, and 285 (79%) had cancer. Continuous sedation was undergone by 49 (14%) patients: 26 (53%) were male, and the median age was 76. Most patients, 46 (94%), had an oncological diagnosis. Only in a minority of cases, the family, 16 (33%), or the patient, 5 (10%), participated in the decision to sedate. Delirium was the most frequent symptom leading to sedation. The medication most used was midazolam (65%). In the multivariable analysis, only age and the combined score were independently associated with sedation; patients <76 years and those with higher levels of suffering had a higher probability of being sedated. Conclusions: The practice of continuous palliative sedation in Portugal is within the range reported in other studies. One particularly relevant point was the low participation of patients and their families in the decision-making process. Each team must have a deep discussion on this aspect.
ISSN:	0825-8597 2369-5293
DOI:	10.1177/08258597241256874