Midazolam prescribing in Paediatric Palliative Care
University of York
Duration of Study in the UK
0 years, 3 months, 31 days
Midazolam is a drug commonly used in paediatric palliative care settings to manage distressing symptoms such as agitation and seizures. Despite its use, evidence supporting the recommended doses and outcomes for midazolam for the management of agitation at end of life care is limited. Prescribing guidance for dosing midazolam are outlined in the latest addition (5th) of the Association for Paediatric Palliative Medicine (APPM) forumulary. The purpose of the formulary is to provide medical staff working in paedatric palliative care (PPC) access to the most up-to-date information and data on the common drugs used within PPC. Despite often relying on the combined experience of experts in the field, the formulary is considered the authoritative and definitive work, and is therefore used as a primary reference source for many textbooks and national research studies. To ensure the appropriate recommendations for midazolam dosing are reflected in the next edition of the formulary, it is essential that the evidence base on midazolam dosing to manage anxiety at end of life is strengthened.
We therefore aim to undertake a prospective research study to understand the doses and indications that children are prescribed midazolam in paediatric palliative care settings. The study will form part of a larger programme of work that aims to improve the safety and efficacy of symptom management for children requiring palliative care, and provide key evidence to inform the next version of the APPM master formulary. Recent topic specific clinical guidelines produced by APPM, with support from Cochrane Response, on agitation and seizure management failed to find adequate evidence on the efficacy of midazolam dosing for children during palliative and end of life care for both seizures and agitation.
North of Scotland Research Ethics Committee 2
Date of REC Opinion
5 Jun 2023
Further Information Favourable Opinion