Systematic review

Task 1.2 Performance of a systematic review of prospective clinical studies on refractory symptoms in palliative patients (M3-15) The researchers at the University of Navarra will lead a review of the literature on prospective clinical studies on refractory symptoms in palliative patients and the role of palliative sedation. The review will include clinical predictors, assessment procedures (process of decision making, involvement of palliative care specialists, expertise and experience to judge the symptom as refractory), and treatment strategies (first line medications and alternatives, initial dose, titration strategies, concomitant use of hydration, monitoring and documenting). The initial results will be send to the collaborating centers asking for their critical suggestions and comments. All the beneficiaries will finally be invited to participate in a consensus meeting on the provisional report to reach an agreement for the content the final drafts of the report. The analysis of the available literature will be useful as a starting point for a further international consensus process on refractory symptoms within the European Association of Palliative Care (EAPC).