Midazolam Indications and Dosing in Palliative Medicine: Results from a Multinational Survey

Despite sparse evidence and limited guidance on indications, use, and dosing, midazolam is widely used in palliative care. We aimed to describe and compare the use of midazolam in three different countries to improve clinical practice in palliative care. We performed an online survey among palliativ...

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Bibliographic Details
Published in:Current oncology (Toronto) 2024-07, Vol.31 (7), p.4093-4104
Main Authors: Tranung, Morten, Solheim, Tora Skeidsvoll, Løhre, Erik Torbjørn, Marsaa, Kristoffer, Faksvåg Haugen, Dagny, Laird, Barry, Thronæs, Morten, Due Larsen, Michael
Format: Article
Language:English
Subjects:
anxiety
Care and treatment
Denmark
dyspnoea
Humans
Midazolam
Midazolam - administration & dosage
Midazolam - therapeutic use
Norway
Opioids
Pain
palliative care
Palliative Care - methods
Palliative Medicine
Practice Patterns, Physicians' - statistics & numerical data
survey
Surveys
Surveys and Questionnaires
United Kingdom
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Summary:Despite sparse evidence and limited guidance on indications, use, and dosing, midazolam is widely used in palliative care. We aimed to describe and compare the use of midazolam in three different countries to improve clinical practice in palliative care. We performed an online survey among palliative care physicians in Norway, Denmark, and the United Kingdom (UK). The focus was indications, dosing, administration, and concomitant drugs. A web-based questionnaire was distributed to members of the respective national palliative medicine associations. The total response rate was 9.4%. Practices in the UK, Norway, and Denmark were overall similar regarding the indications of midazolam for anxiety, dyspnoea, and pain treatment in combination with opioids. However, physicians in the UK used a higher starting dose for anxiety, dyspnoea, and pain treatment compared to Norway and Denmark, as well as a higher maximum dose. Danish physicians preferred, to a higher degree, on-demand midazolam administration. Despite practice similarities in the UK, Norway, and Denmark, differences exist for midazolam dosing and administration in palliative medicine. We demonstrated a lack of consensus on how midazolam should be used in palliative care, setting the stage for future studies on the topic.
ISSN:1718-7729
1198-0052
1718-7729
DOI:10.3390/curroncol31070305