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Dexmedetomidine and clonidine in palliative medicine: multicentric qualitative evaluation
  1. Chloé Prod'homme1,2,
  2. Xavier Werbrouck1,
  3. Magali Pierrat1,
  4. Luc Chevalier1,
  5. Helene Lesaffre1,
  6. Claire Pasqualini1 and
  7. Licia Touzet1
  1. 1 Departement of Palliative Care, Regional and University Hospital Centre Lille, Lille, France
  2. 2 ULR 2694 METRICS, University of Lille, Lille, Hauts-de-France, France
  1. Correspondence to Dr Chloé Prod'homme, Departement of palliative care, Regional and University Hospital Centre Lille, Lille, France; chloe.prodhomme{at}


Objectives Alpha-2 agonists have analgesic and sedative properties that can prove interesting in palliative care. The main objective of this study was to describe the use of clonidine and dexmedetomidine in palliative care units (PCU). The secondary objective was to identify physicians’ perspectives and attitudes toward alpha-2-agonists.

Methods International multicentric qualitative survey of prescribing characteristics and attitudes towards alpha-2 agonist. All 159 PCUs in France, Belgium and French-speaking Switzerland were contacted, and 142 physicians answered the questionnaire (31% participation).

Results 20% of the practitioners surveyed prescribe these molecules are mainly for analgesic and sedative indications. There was considerable heterogeneity in the modalities and dosages of administration. The use of clonidine is more frequent and common in Belgium, while dexmedetomidine is only used in France. There is a high level of satisfaction among practitioners who use these molecules, with the desire of the majority of respondents to obtain additional studies and information on alpha-2-agonists.

Conclusion Alpha-2 agonists are little known and little prescribed by French-speaking palliative care physicians but are of interest because of their potential in this field. Phase 3 studies could justify the use of these molecules in palliative situations and would contribute to harmonising professional practices.

  • symptoms and symptom management
  • hospital care
  • end of life care
  • drug administration

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  • Contributors All authors read and approved the final manuscript. CP and XW designed the study. CP and XW carried out the study. CP, MP, LC, HL, CP and LT were involved in interpreting the study findings. CP and LT wrote the manuscript, which was critically read by all the authors. CP is guarantor of the study. CP affirms that the manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned have been explained. All authors had full access to all the data in the study and can take responsibility for their integrity and the accuracy of their analysis.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer The authors confirmed that all methods were carried out in accordance with relevant guidelines and regulations, particularly the Checklist for Reporting Results of Internet E-Surveys (CHERRIES) developed from Eysenbach G. Improving the quality of Web surveys: the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). J Med Internet Res. 2004 Sep 29;6(3):e34. The details of these criteria can be found in related files.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.