Sebastiano Mercadante1, Giampiero Porzio2, Alessandro Valle3, Federica Aielli2, Alessandra Casuccio4. 1. Pain Relief and Palliative Care Unit, La Maddalena Cancer Center, Palermo, Italy; Palliative Medicine, Department of Anesthesia & Intensive Care, University of Palermo, Palermo, Italy. Electronic address: 03sebelle@gmail.com. 2. Home Care Program, L' Aquila per la vita, L'Aquila, Italy. 3. Home Care Program, Fondazione FARO, Torino, Italy. 4. Department of Sciences for Health Promotion "G. D'Alessandro"-Hygiene Section, University of Palermo, Palermo, Italy.
Abstract
CONTEXT: Home care programs in Italy. OBJECTIVES: The aim of this study was to assess a protocol for palliative sedation (PS) performed at home. METHODS: A total of 219 patients were prospectively assessed to evaluate a PS protocol in patients with advanced cancer followed at home by two home care programs with different territorial facilities. The protocol was based on stepwise administration of midazolam. RESULTS: A total of 176 of the patients died at home, and PS was performed in 24 of these patients (13.6%). Younger patients received the procedure more frequently than older patients (P=0.012). The principal reasons to start PS were agitated delirium (n=20) and dyspnea (n=4). Mean duration of PS was 42.2±30.4 hours, and the mean doses of midazolam were 23-58 mg/day. Both the home care team and the patients' relatives expressed optimal or good levels of satisfaction with the procedure in all but one case, respectively. CONCLUSION: This protocol for PS was feasible and effective in minimizing distress for a subgroup of patients who died at home. The characteristics of patients who may be effectively sedated at home should be better explored in future studies.
CONTEXT: Home care programs in Italy. OBJECTIVES: The aim of this study was to assess a protocol for palliative sedation (PS) performed at home. METHODS: A total of 219 patients were prospectively assessed to evaluate a PS protocol in patients with advanced cancer followed at home by two home care programs with different territorial facilities. The protocol was based on stepwise administration of midazolam. RESULTS: A total of 176 of the patients died at home, and PS was performed in 24 of these patients (13.6%). Younger patients received the procedure more frequently than older patients (P=0.012). The principal reasons to start PS were agitated delirium (n=20) and dyspnea (n=4). Mean duration of PS was 42.2±30.4 hours, and the mean doses of midazolam were 23-58 mg/day. Both the home care team and the patients' relatives expressed optimal or good levels of satisfaction with the procedure in all but one case, respectively. CONCLUSION: This protocol for PS was feasible and effective in minimizing distress for a subgroup of patients who died at home. The characteristics of patients who may be effectively sedated at home should be better explored in future studies.
Authors: Sebastiano Mercadante; Antonello Giarratano; Andrea Cortegiani; Cesare Gregoretti Journal: Support Care Cancer Date: 2017-04-25 Impact factor: 3.603
Authors: Sebastiano Mercadante; Francesco Masedu; Alessandro Mercadante; Franco Marinangeli; Federica Aielli Journal: Support Care Cancer Date: 2017-01-17 Impact factor: 3.603
Authors: Sebastiano Mercadante; Federica Aielli; Francesco Masedu; Marco Valenti; Lucilla Verna; Giampiero Porzio Journal: Support Care Cancer Date: 2015-10-16 Impact factor: 3.603
Authors: Santiago Parra Palacio; Clara Elisa Giraldo Hoyos; Camilo Arias Rodríguez; Daniel Mejía Arrieta; John Jairo Vargas Gómez; Alicia Krikorian Journal: Support Care Cancer Date: 2018-03-29 Impact factor: 3.603
Authors: Sebastiano Mercadante; Francesco Masedu; Isabella Balzani; Daniela De Giovanni; Luigi Montanari; Cristina Pittureri; Raffaella Bertè; Domenico Russo; Laura Ursini; Franco Marinangeli; Federica Aielli Journal: Support Care Cancer Date: 2017-10-05 Impact factor: 3.603