Many Patients Are Under-Sedated During End-of-Life Cancer Care

Sap Partners | Schools of Nursing | <b>The University of Texas MD Anderson Cancer Center</b>

David Hui, MD, MSc, from The University of Texas MD Anderson Cancer Center, discusses findings indicating that patients with agitated delirium may be under-sedated, in accordance with their personalized sedation goal.

During end-of-life care, nearly half of patients with agitated delirium were not receiving the level of sedation pre-described by their caregiver as their personalized sedation goal, according to study results published in Cancer.1

In an interview with Oncology Nursing News®, David Hui, MD, MSc, discusses the implications of these findings, and the need for future research to find better ways to help patients with cancer manage their restlessness during end-of-life care.

“This is an important observation because, as clinicians, we often worry that we are overly sedating patients. [But] it seems that based on the data that is collected, we are not able to hit the hit the targets adequately, and [there] may be some unnecessary restlessness that could be managed a little bit better. We certainly need better research and more new agents to see how we can help control this condition a little bit more, given that it is one of the most distressing manifestations in the last days of life.”

Hui also highlighted the importance of incorporating oncology nurses into any research involving the sedation of patients in this setting.

“This is a study where nurses have a very important role; the nurses are the ones who helped us design the study together with the palliative care team, as an interdisciplinary teamwork… They are the ones who give the study medications. They are the ones who do the monitoring, of the patient's restlessness level, and they are the ones who also fill out their work their perception for how the person is doing in their personalization goal as well. By investing their time in this, they are also helping us to move the field forward.”

Reference

Hui D, De La Rosa A, Urbauer D, Nguyen T, Bruera E. Personalized sedation goal for agitated delirium in p0atients with cancer: balancing comfort and communication. Cancer. 2021;127(54)L4694-4701. doi:10.1002/cncr.33876