BackgroundSedation is used to an increasing extent in end-of-life care. Definitions and indications in this field are based on expert opinions and case series. Little is known about this practice at palliative care units in Austria.MethodsPatients who died in Austrian palliative care units between June 2012 and June 2013 were identified. A predefined set of baseline characteristics and information on sedation during the last two weeks before death were obtained by reviewing the patients’ charts.ResultsThe data of 2414 patients from 23 palliative care units were available for analysis. Five hundred two (21 %) patients received sedation in the last two weeks preceding their death, 356 (71 %) received continuous sedation until death, and 119 (24 %) received intermittent sedation. The median duration of sedation was 48 h (IQR 10–72 h); 168 patients (34 %) were sedated for less than 24 h. Indications for sedation were delirium (51 %), existential distress (32 %), dyspnea (30 %), and pain (20 %). Midazolam was the most frequently used drug (79 %), followed by lorazepam (13 %), and haloperidol (10 %). Sedated patients were significantly younger (median age 67 years vs. 74 years, p ≤ 0.001, r = 0.22), suffered more often from an oncological disease (92 % vs. 82 %, p ≤ 0.001, φ = 0.107), and were hospitalized more frequently (94 % vs. 76 %, p ≤ 0.001, φ = 0.175). The median number of days between admission to a palliative care ward/mobile palliative care team and death did not differ significantly in sedated versus non-sedated patients (10 vs. 9 days; p = 0.491).ConclusionThis study provides insights into the practice of end-of-life sedation in Austria. Critical appraisal of these data will serve as a starting point for the development of nation-wide guidelines for palliative sedation in Austria.

To discover the perception of telemedicine in a sample of physicians not yet participating in telemedicine networks, a questionnaire was sent to doctors in different European countries. The questions covered various general aspects of telemedicine. The percentage of questionnaires returned ranged from 12% (Central Europe) to 27% (Spain). Apart from the rather disappointing response rates the results document a strong interest in telemedicine on the part of the physicians surveyed. Knowledge of the existence of telemedicine was high. Most of the respondents would have liked to have had their clinic's telemedicine system in their own laboratory. More than 50% of the physicians thought that their work would be improved by using telemedicine. Respondents from Central Europe were significantly less enthusiastic about telemedicine than those from other regions. However, the answers to the majority of the questions were similar in the different groups.

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