Deep Sedations, Palliative Care
Conditions
Keywords
palliative care, prevalence, terminal phase
Brief summary
This nation-wide, multicentric, prospective and cross-sectional study aims to estimate the prevalence of deep sedations (i.e. with a -4 or -5 score at the Richmond scale at the induction time) for patients in terminal phase and receiving cares from a specialized palliative care facility (palliative care units, dedicated beds in acute units, mobile teams for inpatient or outpatients or home-based structures) in France.
Detailed description
Inducing a deep sedation in palliative care is a sensitive practice. The abolition of the communication in a crucial moment of life for the patients is particularly challenging. This practice implies particular experiences for families and caregivers, often increased by the deepness of the sedation. In France, the Claeys-Leonetti law has added additional indications of deep sedation. The lack of data on the prevalence of this practice in palliative care complicates the implementation of research projects and the improvement of professionals skills. In existing literature, the proportions of patients thus sedated varied from 2.5 to 14.5%. To our knowledge, no study on the prevalence of deep sedative practices in terminal diseases has been carried out in France. This observational study will help to better understand the real importance of this practice among each palliative care structures. They will also serve to build research projects on this theme supporting improvement of care for this population. In this study, the deep sedation is defined as a sedation directly inducing from the induction time a score of -4 or -5 at the Richmond vigilance scale (or a clinically equivalent state for the investigator) as defined by the French society of palliative care and accompanying. The day of inclusion, the investigator will collect the information about the structure of palliative care (type, team composition, number of patients with an on-going terminal disease), the characteristics of the sedated patient(s) (age, disease, treatments) and of the sedation (sedative molecules, assessment of vigilance, consents and decision-making process). In case of an on-going sedation previously initiated but still in progress the day of inclusion, the investigator will retrospectively collect the required data.
Interventions
OTHERType of sedations
Estimate the prevalence of deep sedations (i.e. with a -4 or -5 score at the Richmond scale at the induction time) for patients in terminal phase and receiving cares from a specialized palliative care facility
Sponsors
University Hospital, Bordeaux
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
6 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Major, minor, major with legal protection patient * Follow-up by a specialized palliative care facility; * Palliative situation of a disease (non-curable); * In terminal palliative phase (life expectancy estimated by the investigator =\< 4 weeks)
Exclusion criteria
* Not followed by a specialized palliative care facility; * In curative situation (curable); * In non-terminal palliative phase (life expectancy estimated by the investigator \> 4 weeks).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Determine the number of patient with deep sedation | Day 1 | The primary endpoint will be the prevalence of deep sedations among all the included patients with a terminal disease receiving cares from a specialized palliative care facility. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Determine the number of patient by type of disease | Day 1 | deep palliative sedations for each sub-group of duration, depth and consent regarding the SEDAPALL classification |
| Describe the sedative therapies used | Day 1 | Comparative of sedative therapies used |
Countries
France
Outcome results
None listed