Acceptability of sedation monitoring in palliative care
Research type
Research Study
Full title
I-CAN-CARE 1.3: Acceptability of sedation monitoring in palliative care: patient and relative perspectives
IRAS ID
199211
Contact name
Emily Ikelle
Contact email
Sponsor organisation
University College London
Duration of Study in the UK
0 years, 8 months, 7 days
Research summary
Recent reports regarding palliative and end-of-life care highlight particular areas where further research and/or improvement of care might be of particular benefit. The 2015 “Dying without Dignity” report of the UK Parliamentary and Health Service Ombudsman identified six key aspects of care of dying patients which needed improvement. Three were: “not recognising when patients are dying”, “poor symptom control (pain and agitation)”, and “communication”. Reports addressing research priorities identify similar points. The 2013 “Neuberger report” recommended more research into improving the accuracy of prognoses, and in 2015 the palliative care research priorities identified by the Palliative and End-of-life care Priority Setting Partnership (PeolcPSP) included managing symptoms and medication, and improving support for carers and families.
Some people receiving palliative care become distressed and agitated towards the end of their lives. Sedative medication may be used to help calm them and manage their distress and agitation, sometimes administered through a "syringe driver", which provides a continuous dose of the medication. The depth of sedation of the person is generally assessed informally, if at all, and seldom monitored objectively. In other settings, such as intensive care, depth of sedation may be assessed via technical devices, such as “Bispectral index” (BIS) technology, whereby a sensory strip is applied to the sedated person’s forehead and their brain activity then monitored via a display. BIS has been used in a few palliative care settings and research studies outside the UK, but its use in UK palliative care has not been assessed as yet.
We would like to explore the views of people providing and receiving palliative care on the possible introduction of BIS technology into palliative care. As a first step, we wish to investigate what patients and their relatives think about the acceptability of monitoring sedation in this way.
REC name
London - Camberwell St Giles Research Ethics Committee
REC reference
16/LO/0686
Date of REC Opinion
3 Jun 2016
REC opinion
Favourable Opinion