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

Autor:	Ferraz-Gonçalves JA; Faculty of Medicine, Porto University, Porto, Portugal., Flores A; Department of Palliative Care, Unidade Local de Saúde do Nordeste, Macedo de Cavaleiros, Portugal., Silva AA; Department of Palliative Care, Serviço de Saúde da Região Autónoma da Madeira (SESARAM), Funchal, Portugal., Simões A; Hospital Palliative Care Team and Home Care Unit, Portuguese Oncology Institute of Lisbon, Lisbon, Portugal., Pais C; Clinical Academic Center of Trás-os-Montes and Alto Douro - Professor Doctor Nuno Grande - CACTMAD, Vila Real, Portugal., Melo C; Community Team of Palliative Care, ACES Lisboa Ocidental e Oeiras, Lisbon, Portugal., Pirra D; Department of Palliative Care, Hospital Santa Luzia, Elvas, Portugal., Coelho D; Department of Palliative Care, Centro Hospitalar Universitário do Algarve, Faro, Portugal., Conde L; Community Team of Palliative Care, Maia/Valongo, Portugal., Real L; Department of Palliative Care, Hospital Santa Luzia, Elvas, Portugal., Feio M; Hospital Palliative Care Team and Home Care Unit, Portuguese Oncology Institute of Lisbon, Lisbon, Portugal., Barbosa M; Community Team of Palliative Care, Maia/Valongo, Portugal., Martins ML; Clinical Academic Center of Trás-os-Montes and Alto Douro - Professor Doctor Nuno Grande - CACTMAD, Vila Real, Portugal., Areias M; Department of Palliative Care, Unidade Local de Saúde do Nordeste, Macedo de Cavaleiros, Portugal., Muñoz-Romero R; Department of Palliative Care, Centro Hospitalar Universitário do Algarve, Faro, Portugal., Ferreira RC; Community Team of Palliative Care, ACES Lisboa Ocidental e Oeiras, Lisbon, Portugal., Freitas S; Department of Palliative Care, Serviço de Saúde da Região Autónoma da Madeira (SESARAM), Funchal, Portugal.
Jazyk:	angličtina
Zdroj:	Journal of palliative care [J Palliat Care] 2025 Jan; Vol. 40 (1), pp. 72-78. Date of Electronic Publication: 2024 May 25.
DOI:	10.1177/08258597241256874
Abstrakt:	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. Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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