Development of a Complex Intervention to Support the Use of Sedative Drugs in Specialist Palliative Care (iSedPall)

Kauzner S, Schneider M, Heckel M, Klein C, Bausewein C, Schildmann E, Bazata J, Kolmhuber S, Krauss SH, Odierna B, Rémi C, Schildmann J, Kremling A, Jäger C, Ziegler K, Ostgathe C (2024)

Publication Type: Journal article

Publication year: 2024

Journal

Palliative Medicine Reports Mary Ann Liebert

Book Volume: 5

Pages Range: 527-536

Journal Issue: 1

DOI: 10.1089/pmr.2024.0042

Abstract

Background: The option of intentional sedation to relieve intolerable suffering from treatment-refractory symptoms may elicit a feeling of safety for patients and informal caregivers as a last resort if the situation becomes unbearable. Many health care professionals feel uncomfortable and insecure in conducting intentional sedation due to specific challenges. We developed a complex intervention to support best practice use of sedative drugs in specialist palliative care in Germany based on previously published recommendations. This article aims at reporting the development of the intervention. Methods: The development of the intervention was based on theory and existing evidence with active stakeholder participation and patient and public involvement, following the updated Medical Research Council (MRC) Framework on complex interventions. A “Theory of Change,” drawing on expert-approved best practice recommendations and applying user-centered methods, fostered the development. The process encompassed study preparation, development of the elements of the intervention, and designing the multimodal intervention. For reporting, we adhere to the Guidance for Reporting Intervention Development framework. Results: The intervention is aimed at health care professionals working in specialist palliative care (inpatient and homecare settings) and consists of several components: (1) a screening tool, (2) the individual elements of the intervention, and (3) educational material for health care professionals to support them using the intervention. Additional information material was developed for patients and informal caregivers. Despite the benefits of stakeholder involvement, we faced some barriers due to limited health care staff and time resources and reservations regarding research in general. Discussion: A pilot study is planned for testing the overall feasibility of the intervention and exploring possible benefits for health care professionals to inform a subsequent fully powered implementation study. To deal with the challenges, we stayed in contact with the health care teams, maintained transparency, and provided opportunities for active participation.

Authors with CRIS profile

Saskia Kauzner Department of Palliative Medicine Manuela Schneider Department of Palliative Medicine Maria Heckel Department of Palliative Medicine Carsten Klein Department of Palliative Medicine Christian Jäger Lehrstuhl für Strafrecht, Strafprozessrecht, Wirtschafts- und Medizinstrafrecht Kerstin Ziegler Institut für Strafrecht, Strafprozessrecht, Kriminologie Christoph Ostgathe Department of Palliative Medicine

Involved external institutions

Martin-Luther-Universität Halle-Wittenberg (MLU) DE Germany (DE) Klinikum der Universität München DE Germany (DE)

How to cite

APA:

Kauzner, S., Schneider, M., Heckel, M., Klein, C., Bausewein, C., Schildmann, E.,... Ostgathe, C. (2024). Development of a Complex Intervention to Support the Use of Sedative Drugs in Specialist Palliative Care (iSedPall). Palliative Medicine Reports, 5(1), 527-536. https://doi.org/10.1089/pmr.2024.0042

MLA:

Kauzner, Saskia, et al. "Development of a Complex Intervention to Support the Use of Sedative Drugs in Specialist Palliative Care (iSedPall)." Palliative Medicine Reports 5.1 (2024): 527-536.

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