Development of a clinical guideline for palliative sedation therapy using the Delphi method.
BACKGROUND
Although palliative sedation therapy is often used in palliative care settings, no clinical guideline is available.


OBJECTIVE
To construct a clinical guideline for palliative sedation therapy.


METHODS
The consensus methods using the Delphi technique on the basis of a systematic literature review was used.


METHODS
A national multidisciplinary committee (five palliative care physicians, four nurses, two oncologists, two psychiatrists, two anesthesiologists, two bioethicists, a medical social worker, and a lawyer).


METHODS
Validity scoring based on the Delphi method and feasibility.


RESULTS
After three sequential sessions of discussion by the Delphi method, an external review by specialists, end-users, and bereaved family members, and a field test, a clinical guideline for palliative sedation therapy was constructed. This guideline includes definitions of palliative sedation therapy, description of the ethical basis of palliative sedation therapy, recommendations about clinical practices in continuous-deep sedation, and diagrams illustrating the clinical application of continuous-deep sedation.


CONCLUSIONS
We constructed a clinical guideline for palliative sedation therapy using the Delphi technique. The clinical efficacy of this guideline should be tested in the future.
Morita
Tatsuya
T
Department of Palliative and Supportive Care, Palliative Care Team, Seirei Hospice, Seirei Mikatabara Hospital, 3453 Mikatabara-cho, Hamamatsu, Shizuoka 433-8558, Japan. tmorita@sis.seirei.or.jp
Bito
Seiji
S
Kurihara
Yukie
Y
Uchitomi
Yosuke
Y
D003697:Delphi Technique; D004333:Drug Administration Routes; D004992:Ethics, Medical; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007564:Japan; D010166:Palliative Care; D017410:Practice Guidelines as Topic
D006993:Hypnotics and Sedatives