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Revised European Association for Palliative Care (EAPC) recommended framework on palliative sedation: An international Delphi study

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Revised European Association for Palliative Care (EAPC) recommended framework on palliative sedation: An international Delphi study. / Surges, Séverine M; Brunsch, Holger; Jaspers, Birgit et al.
In: Palliative Medicine, Vol. 38, No. 2, 29.02.2024, p. 213-228.

Research output: Contribution to Journal/Magazine › Journal article › peer-review

Harvard

Surges, SM, Brunsch, H, Jaspers, B, Apostolidis, K, Cardone, A, Centeno, C, Cherny, N, Csikós, À, Fainsinger, R, Garralda, E, Ling, J, Menten, J, Mercadante, S, Mosoiu, D, Payne, S, Preston, N, Van den Block, L, Hasselaar, J & Radbruch, L 2024, 'Revised European Association for Palliative Care (EAPC) recommended framework on palliative sedation: An international Delphi study', Palliative Medicine, vol. 38, no. 2, pp. 213-228. https://doi.org/10.1177/02692163231220225

APA

Surges, S. M., Brunsch, H., Jaspers, B., Apostolidis, K., Cardone, A., Centeno, C., Cherny, N., Csikós, À., Fainsinger, R., Garralda, E., Ling, J., Menten, J., Mercadante, S., Mosoiu, D., Payne, S., Preston, N., Van den Block, L., Hasselaar, J., & Radbruch, L. (2024). Revised European Association for Palliative Care (EAPC) recommended framework on palliative sedation: An international Delphi study. Palliative Medicine, 38(2), 213-228. https://doi.org/10.1177/02692163231220225

Vancouver

Surges SM, Brunsch H, Jaspers B, Apostolidis K, Cardone A, Centeno C et al. Revised European Association for Palliative Care (EAPC) recommended framework on palliative sedation: An international Delphi study. Palliative Medicine. 2024 Feb 29;38(2):213-228. Epub 2024 Jan 31. doi: 10.1177/02692163231220225

Author

Surges, Séverine M ; Brunsch, Holger ; Jaspers, Birgit et al. / Revised European Association for Palliative Care (EAPC) recommended framework on palliative sedation : An international Delphi study. In: Palliative Medicine. 2024 ; Vol. 38, No. 2. pp. 213-228.

Bibtex

@article{cc3418c6b1e94b0895af0e0b271ee89e,
title = "Revised European Association for Palliative Care (EAPC) recommended framework on palliative sedation: An international Delphi study",
abstract = "Background: The European Association for Palliative Care (EAPC) acknowledges palliative sedation as an important, broadly accepted intervention for patients with life-limiting disease experiencing refractory symptoms. The EAPC therefore developed 2009 a framework on palliative sedation. A revision was needed due to new evidence from literature, ongoing debate and criticism of methodology, terminology and applicability. Aim: To provide evidence- and consensus-based guidance on palliative sedation for healthcare professionals involved in end-of-life care, for medical associations and health policy decision-makers. Design: Revision between June 2020 and September 2022 of the 2009 framework using a literature update and a Delphi procedure. Setting: European. Participants: International experts on palliative sedation (identified through literature search and nomination by national palliative care associations) and a European patient organisation. Results: A framework with 42 statements for which high or very high level of consensus was reached. Terminology is defined more precisely with the terms suffering used to encompass distressing physical and psychological symptoms as well as existential suffering and refractory to describe the untreatable (healthcare professionals) and intolerable (patient) nature of the suffering. The principle of proportionality is introduced in the definition of palliative sedation. No specific period of remaining life expectancy is defined, based on the principles of refractoriness of suffering, proportionality and independent decision-making for hydration. Patient autonomy is emphasised. A stepwise pharmacological approach and a guidance on hydration decision-making are provided. Conclusions: This is the first framework on palliative sedation using a strict consensus methodology. It should serve as comprehensive and soundly developed information for healthcare professionals.",
keywords = "Deep sedation, Delphi consensus (as the MeSH term consensus is not further defined), Europe, Palliative sedation (as the MeSH Terms refers only to one type of sedation), consensus, end-of-life, palliative care, practice guideline, suffering, terminal care",
author = "Surges, {S{\'e}verine M} and Holger Brunsch and Birgit Jaspers and Kathi Apostolidis and Antonella Cardone and Carlos Centeno and Nathan Cherny and {\`A}gnes Csik{\'o}s and Robin Fainsinger and Eduardo Garralda and Julie Ling and Johan Menten and Sebastiano Mercadante and Daniela Mosoiu and Sheila Payne and Nancy Preston and {Van den Block}, Lieve and Jeroen Hasselaar and Lukas Radbruch",
year = "2024",
month = feb,
day = "29",
doi = "10.1177/02692163231220225",
language = "English",
volume = "38",
pages = "213--228",
journal = "Palliative Medicine",
issn = "0269-2163",
publisher = "SAGE Publications Ltd",
number = "2",

}

RIS

TY - JOUR

T1 - Revised European Association for Palliative Care (EAPC) recommended framework on palliative sedation

T2 - An international Delphi study

AU - Surges, Séverine M

AU - Brunsch, Holger

AU - Jaspers, Birgit

AU - Apostolidis, Kathi

AU - Cardone, Antonella

AU - Centeno, Carlos

AU - Cherny, Nathan

AU - Csikós, Àgnes

AU - Fainsinger, Robin

AU - Garralda, Eduardo

AU - Ling, Julie

AU - Menten, Johan

AU - Mercadante, Sebastiano

AU - Mosoiu, Daniela

AU - Payne, Sheila

AU - Preston, Nancy

AU - Van den Block, Lieve

AU - Hasselaar, Jeroen

AU - Radbruch, Lukas

PY - 2024/2/29

Y1 - 2024/2/29

N2 - Background: The European Association for Palliative Care (EAPC) acknowledges palliative sedation as an important, broadly accepted intervention for patients with life-limiting disease experiencing refractory symptoms. The EAPC therefore developed 2009 a framework on palliative sedation. A revision was needed due to new evidence from literature, ongoing debate and criticism of methodology, terminology and applicability. Aim: To provide evidence- and consensus-based guidance on palliative sedation for healthcare professionals involved in end-of-life care, for medical associations and health policy decision-makers. Design: Revision between June 2020 and September 2022 of the 2009 framework using a literature update and a Delphi procedure. Setting: European. Participants: International experts on palliative sedation (identified through literature search and nomination by national palliative care associations) and a European patient organisation. Results: A framework with 42 statements for which high or very high level of consensus was reached. Terminology is defined more precisely with the terms suffering used to encompass distressing physical and psychological symptoms as well as existential suffering and refractory to describe the untreatable (healthcare professionals) and intolerable (patient) nature of the suffering. The principle of proportionality is introduced in the definition of palliative sedation. No specific period of remaining life expectancy is defined, based on the principles of refractoriness of suffering, proportionality and independent decision-making for hydration. Patient autonomy is emphasised. A stepwise pharmacological approach and a guidance on hydration decision-making are provided. Conclusions: This is the first framework on palliative sedation using a strict consensus methodology. It should serve as comprehensive and soundly developed information for healthcare professionals.

AB - Background: The European Association for Palliative Care (EAPC) acknowledges palliative sedation as an important, broadly accepted intervention for patients with life-limiting disease experiencing refractory symptoms. The EAPC therefore developed 2009 a framework on palliative sedation. A revision was needed due to new evidence from literature, ongoing debate and criticism of methodology, terminology and applicability. Aim: To provide evidence- and consensus-based guidance on palliative sedation for healthcare professionals involved in end-of-life care, for medical associations and health policy decision-makers. Design: Revision between June 2020 and September 2022 of the 2009 framework using a literature update and a Delphi procedure. Setting: European. Participants: International experts on palliative sedation (identified through literature search and nomination by national palliative care associations) and a European patient organisation. Results: A framework with 42 statements for which high or very high level of consensus was reached. Terminology is defined more precisely with the terms suffering used to encompass distressing physical and psychological symptoms as well as existential suffering and refractory to describe the untreatable (healthcare professionals) and intolerable (patient) nature of the suffering. The principle of proportionality is introduced in the definition of palliative sedation. No specific period of remaining life expectancy is defined, based on the principles of refractoriness of suffering, proportionality and independent decision-making for hydration. Patient autonomy is emphasised. A stepwise pharmacological approach and a guidance on hydration decision-making are provided. Conclusions: This is the first framework on palliative sedation using a strict consensus methodology. It should serve as comprehensive and soundly developed information for healthcare professionals.

KW - Deep sedation

KW - Delphi consensus (as the MeSH term consensus is not further defined)

KW - Europe

KW - Palliative sedation (as the MeSH Terms refers only to one type of sedation)

KW - consensus

KW - end-of-life

KW - palliative care

KW - practice guideline

KW - suffering

KW - terminal care

U2 - 10.1177/02692163231220225

DO - 10.1177/02692163231220225

M3 - Journal article

C2 - 38297460

VL - 38

SP - 213

EP - 228

JO - Palliative Medicine

JF - Palliative Medicine

SN - 0269-2163

IS - 2

ER -