Spanish and Portuguese Societies of Internal Medicine consensus guideline about best practice in end-of-life care

Abstract

Aim: To develop consensus recommendations about good clinical practice rules for caring end-of-life patients.

Methods: A steering committee of 12 Spanish and Portuguese experts proposed 37 recommendations. A two rounds Delphi method was performed, with participation of 105 panelists including internists, other clinicians, nurses, patients, lawyers, bioethicians, health managers, politicians and journalists. We sent a questionnaire with 5 Likert-type answers for each recommendation. Strong consensus was defined when > 95% answers were completely agree or > 90% were agree or completely agree; and weak consensus when > 90% answers were completely agree or > 80% were agree or completely agree.

Results: The panel addressed 7 specific areas for 37 recommendations spanning: identification of patients; knowledge of the disease, values and preferences of the patient; information; patient's needs; support and care; palliative sedation, and after death care.

Conclusions: The panel formulated and provided the rationale for recommendations on good clinical practice rules for caring end-of-life patients.

Keywords: Best practice; Buenas prácticas; Consenso; Consensus; Cuidados al final de la vida; End-of-life care; Guideline; Guía de práctica clínica.