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The use of proportional palliative sedation for the relief of refractory symptoms: an international multicenter study

Objective

Due to the rise in cancer and multiple chronic disease, the number of patients with refractory symptoms, ie severe symptoms where conventional treatment options fail, is likely to increase. In such cases palliative sedation (PS) can be indicated which involves the intentional lowering of consciousness at the end of life. However PS is too often restricted to continuous deep sedation and confused with hastening of death. This proposal offers a modified concept, namely proportional PS, with titration of sedatives up to the point of symptom control to improve patient comfort. Firstly, the project will offer a review about state-of-the-art refractory symptom management and a country survey. Secondly, an observational multicenter study will be performed in five countries to study the effect of proportional PS at patient comfort and symptom relief. Thirdly, a multiple case study of 50 cases will investigate caregivers and family experiences. Fourthly, moral case deliberation will be studied as a tool to improve multidisciplinary decision making for the treatment of refractory symptoms/PS in 16 clinical centers in 8 countries, including the effect on caregiver emotional distress. Fifthly, a Cost Consequence Analysis will be provided to feed a policy workshop and recommendations for the further development of palliative sedation in Europe. Sixthly, a revision of the 2009 EAPC framework for PS will be undertaken, using a Delphi procedure. Finally, a free online education programme will be delivered together with an abook and a closing congress and webinar to support dissemination. The project consortium consists of experts in the field of palliative care and PS from 8 North-Western, Southern, and Central-Eastern European countries. Renowned advisory board members are involved among which the European Cancer Patient Coalition to foster the patient perspective. A dedicated European taksforce for PS is foreseen as a follow up after the project's finalization.

Field of science

  • /medical and health sciences/clinical medicine/oncology/cancer

Call for proposal

H2020-SC1-2018-Single-Stage-RTD
See other projects for this call

Funding Scheme

RIA - Research and Innovation action

Coordinator

STICHTING KATHOLIEKE UNIVERSITEIT
Address
Geert Grooteplein Noord 9
6525 EZ Nijmegen
Netherlands
Activity type
Higher or Secondary Education Establishments
EU contribution
€ 783 442

Participants (9)

UNIVERSIDAD DE NAVARRA
Spain
EU contribution
€ 607 125
Address
Campus Universitario Edificio Central
31080 Pamplona
Activity type
Higher or Secondary Education Establishments
PECSI TUDOMANYEGYETEM - UNIVERSITY OF PECS
Hungary
EU contribution
€ 279 250
Address
Vasvari Pal Utca 4
7622 Pecs
Activity type
Higher or Secondary Education Establishments
KATHOLIEKE UNIVERSITEIT LEUVEN
Belgium
EU contribution
€ 600 000
Address
Oude Markt 13
3000 Leuven
Activity type
Higher or Secondary Education Establishments
Hospice Casa Sperantei
Romania
EU contribution
€ 200 125
Address
Street Sitei 17A
500074 Brasov
Activity type
Research Organisations
UNIVERSITATSKLINIKUM BONN
Germany
EU contribution
€ 584 000
Address
Venusberg-campus 1
53127 Bonn
Activity type
Higher or Secondary Education Establishments
UNIVERSITY OF LANCASTER
United Kingdom
EU contribution
€ 502 016,25
Address
Bailrigg
LA1 4YW Lancaster
Activity type
Higher or Secondary Education Establishments
EUROPEAN ASSOCIATION OF PALLIATIVE CARE
Belgium
EU contribution
€ 140 000
Address
Toekomststraat 36
1800 Vilvoorde
Activity type
Other
LA MADDALENA SPA
Italy
EU contribution
€ 321 250
Address
Via San Lorenzo 312
90146 Palermo
Activity type
Private for-profit entities (excluding Higher or Secondary Education Establishments)
EUROPEAN CANCER PATIENT COALITION
Belgium
EU contribution
€ 16 312
Address
Rue Montoyer 40
1000 Bruxelles
Activity type
Other