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BMJ Support Palliat Care 2:310-311 doi:10.1136/bmjspcare-2012-000372
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  1. Jason Boland
  1. Senior lecturer and honorary consultant in palliative medicine, Hull York Medical School, University Of Hull, UK

Palliative sedation in end-of-life care and survival: a systematic review

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This systematic review aimed to compare the survival of sedated and non-sedated patients and analysed 11 articles (1807 patients; 621 sedated) including four prospective and seven retrospective non-randomised studies. Sedation was most frequently used for delirium at the end of life; other common reasons were dyspnoea, pain and psychological distress. Benzodiazepines were the most common drug group used, followed by antipsychotics. This review found no difference in survival of sedated and non-sedated patients, although it recognises the lack of randomised controlled trial evidence.

The disparity between patient and nurse symptom rating in a hospice population

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Although symptom rating should be by self-report these are often completed by nurses. This study compared the simultaneous symptom ratings of patients and nurses in 64 symptom ratings from 29 patients. There was more correlation for nausea, bowels, and breathing questions, and the least for appetite. There were wide differences in reporting and nurses generally underreported symptoms. The authors concluded that as the nurses’ symptom assessment only moderately correlates with patients’ symptom rating, this can misrepresent the patient's symptoms and self-reporting should be used unless the patient cannot do so.

Autonomic dysfunction in patients with advanced cancer: prevalence, clinical correlates and challenges in assessment

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