• Der Schmerz · Feb 2022

    [Perceptions on the use of opioids in COVID-19 : A survey of members of the German Association for Palliative Medicine].

    • Vera Peuckmann-Post, Alexandra Scherg, Norbert Krumm, Carolin Hagedorn, Lukas Radbruch, Andras Keszei, Roman Rolke, and Frank Elsner.
    • Klinik für Palliativmedizin, Medizinische Fakultät, RWTH Aachen University, Pauwelsstr 30, 52074, Aachen, Deutschland. vpeuckmann@ukaachen.de.
    • Schmerz. 2022 Feb 1; 36 (1): 192919-29.

    BackgroundOpioids efficiently alleviate pain and dyspnea. However, guidelines on symptom management with opioids differ, which may lead to an uncertainty concerning opioid indication and ethical implication among medical staff, especially when caring for COVID-19 patients.AimsWe aimed to examine the perception of members of the German Association for Palliative Medicine (DGP) concerning the administration of morphine as the gold standard opioid (subsequently termed M/O) for symptom control within and outside of a palliative care (PC) setting, including care for COVID-19 patients.MethodsDGP members received an anonymized online questionnaire (Survey Monkey®) containing questions regarding their perception of symptom management with M/O in general and in particular concerning COVID-19 patients. Participants were asked to rate their perception within and outside of a PC setting.ResultsOf the 6129 DGP members, N = 506 participated. DGP physicians and nurses perceived handling of M/O as "certain and confident" (98%) and "clearly regulated" within PC (95%) but rated it significantly lower for outside PC (48%/38%). When caring for COVID-19 patients, handling of M/O was even less often rated "certain and confident" (26%) or "clearly regulated" (23%) for outside PC. Dyspnea (99%/52%), relief from the dying process (62%/37%), restlessness (30%/15%) and fear or panic (27%/13%) were more frequently rated as general indications for morphine within versus outside PC. Most participants (89%) wished to involve palliative care consultation teams.ConclusionsDGP members perceived substantial uncertainty in the handling of M/O for medical fields outside PC. Uniform interdisciplinary guidelines for symptom control, more education, and involvement of a PC consultation team should be increasingly considered in the future.© 2021. The Author(s).

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