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  • Lindqvist, OlavKarolinska Institutet (author)

Four essential drugs needed for quality care of the dying : a Delphi-study based international expert consensus opinion

  • Article/chapterEnglish2013

Publisher, publication year, extent ...

  • Mary Ann Liebert Inc,2013
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:shh-1228
  • https://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-1228URI
  • https://doi.org/10.1089/jpm.2012.0205DOI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-7129URI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:125989929URI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-66416URI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Abstract Purpose: The majority of dying patients do not have access to necessary drugs to alleviate their most common symptoms, despite evidence of drug efficacy. Our aim was to explore the degree of consensus about appropriate pharmacological treatment for common symptoms in the last days of life for patients with cancer, among physicians working in specialist palliative care. Material and methods: Within OPCARE9, a European Union seventh framework project aiming to optimize end-of-life cancer care, we conducted a Delphi survey among 135 palliative care clinicians in nine countries. Physicians were initially asked about first and second choice of drugs to alleviate anxiety, dyspnea, nausea and vomiting, pain, respiratory tract secretions (RTS), as well as terminal restlessness. Results: Based on a list of 35 drugs mentioned at least twice in the first round (n=93), a second Delphi round was performed to determine ≤5 essential drugs for symptom alleviation in the last 48 hours of life that should be available even outside specialist palliative care. There was ≥80% consensus among the participants (n=90) regarding morphine, midazolam, and haloperidol as essential drugs. For RTS, there was consensus about use of an antimuscarinic drug, with 9%-27% of the physicians each choosing one of four different drugs. Conclusion: Based on this consensus opinion and other literature, we suggest four drugs that should be made available in all settings caring for dying patients with cancer, to decrease the gap between knowledge and practice: morphine (i.e., an opioid), midazolam (a benzodiazepine), haloperidol (a neuroleptic), and an antimuscarinic.

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Added entries (persons, corporate bodies, meetings, titles ...)

  • Lundquist, GunillaUmeå universitet,Onkologi(Swepub:umu)gulu0011 (author)
  • Dickman, Andrew (author)
  • Bükki, Johannes (author)
  • Lunder, Urska (author)
  • Lundh Hagelin, CarinaKarolinska Institutet,Sophiahemmet Högskola,Stiftelsen Stockholms sjukhem; Karolinska institutet; Sophiahemmet högskola(Swepub:esh)carlun (author)
  • Rasmussen Holritz, BirgitUmeå universitet,Institutionen för omvårdnad(Swepub:umu)bira0001 (author)
  • Sauter, Sylvia (author)
  • Tishelman, CarolKarolinska Institutet (author)
  • Fürst, Carl Johan (author)
  • Karolinska InstitutetOnkologi (creator_code:org_t)

Related titles

  • In:Journal of Palliative Medicine: Mary Ann Liebert Inc16:1, s. 38-431096-62181557-7740

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