Feasibility of monitoring sedative use in palliative care

  • Research type

    Research Study

  • Full title

    Is structured monitoring of sedative use useful, feasible and acceptable for palliative care patients in a UK hospice? A study for I-CAN-CARE

  • IRAS ID

    224551

  • Contact name

    Nikkayla Dixon

  • Contact email

    uclh.randd@nhs.net

  • Sponsor organisation

    University College London

  • Clinicaltrials.gov Identifier

    MCCC-FBFO-16-U, Baillie Marie Curie PhD Fellowship; Z6364106/2017/05/93 , UCL Data Protection Registration

  • Duration of Study in the UK

    1 years, 6 months, 17 days

  • Research summary

    Background
    Sedative medication are used to help some people receiving palliative care towards the end of life with distress and agitation which is otherwise unmanageable. The level of consciousness is usually assessed informally, and seldom monitored objectively. In settings such as intensive care, however, conscious level is often assessed via technical devices, such as “Bispectral index” (BIS) technology. This kind of technology might help clinicians to monitor conscious level more precisely, and so more accurately titrate doses of medication for each individual. However, while BIS has been used in a few palliative care settings outside the UK, its use in palliative care in the UK has not yet been studied. We aim to address this gap in the literature through this doctoral research project.

    Objective
    To determine whether BIS technology and/or other structured monitoring techniques are useful, feasible and acceptable for monitoring sedative use in palliative care patients in a UK hospice.

    Methods
    We aim to recruit 100 palliative care hospice inpatients to be monitored with the BIS technology for 4 hours (+30 minutes). The BIS operates through a strip sensor, attached to the person’s forehead with sticky pads, and connected to a monitoring device plus display screen.
    Patients who have taken part in the initial monitoring will be asked whether they would like to participate in an additional 4 hour period of monitoring and/or in a face-to-face individual interview with a researcher where their views on the BIS will be discussed. Patients who are agreeable to take part in either of these, will be given separate information leaflets and consent forms.

    Next steps following this study
    If the BIS proves to be a useful, feasible and acceptable tool for the monitoring of sedative use in palliative care, a larger study will be developed, which will evaluate the effectiveness and cost-effectiveness of the BIS technology.

  • REC name

    London - Camden & Kings Cross Research Ethics Committee

  • REC reference

    17/LO/1430

  • Date of REC Opinion

    26 Sep 2017

  • REC opinion

    Favourable Opinion