Attitudes of palliative home care physicians towards palliative sedation at home in Italy

Background: Information about the attitudes towards palliative sedation (PS) at home is limited. Aim: The aim of this survey was to assess the attitudes of palliative care physicians in Italy regarding PS at home. Design: A questionnaire was submitted to a sample of palliative care physicians, asking information about their activity and attitudes towards PS at home. Setting: This is a survey of home care physicians in Italy who were involved in end-of-life care decisions at home. Results: One hundred and fifty participants responded. A large heterogeneity of home care organizations that generate some problems was found. Indications, intention and monitoring of PS seem to be appropriate, although some cultural and logistic conditions were limiting the use of PS. Specialized home care physicians are almost involved to start PS at home. Midazolam was seldom available at home and opioids were more frequently used. Conclusion: These data should prompt health care agencies to make a minimal set of drugs easily available for home care. Further research is necessary to compare attitudes in countries with different sociocultural profiles.