RT Journal Article SR Electronic T1 Palliative sedation in Dutch general practice from 2005 to 2011: a dynamic cohort study of trends and reasons JF British Journal of General Practice JO Br J Gen Pract FD British Journal of General Practice SP e669 OP e675 DO 10.3399/bjgp13X673676 VO 63 IS 615 A1 Gé A Donker A1 Frank G Slotman A1 Peter Spreeuwenberg A1 Anneke L Francke YR 2013 UL http://bjgp.org/content/63/615/e669.abstract AB Background Little is known about the quantity and reasons for use of palliative sedation in general practice.Aim To gain more insight into the trends of and reasons for palliative sedation in Dutch general practice.Design and setting Dynamic cohort study using registrations and questionnaire data of Dutch GPs.Method Data collected in the years from 2005 until 2011 in the Dutch Sentinel General Practice Network were analysed. Trends and reasons for use of palliative sedation were analysed using multilevel analyses to control for clustering of observations within general practices.Results From 2005–2011, 183 cases were reported from 56 general practices. The incidence of palliative sedation fluctuated between 33.7 per 100 000 patients in 2006 and 15.2 in 2011. No rise or decline during the period was observed. Palliative sedation was applied in 5.7% of all deaths and most frequently used in younger patients with cancer. The mean number of refractory symptoms was 2.6 (SD 1.2); pain (69.4%), dyspnoea (53.0%), and fear (39.3%). Patient involvement in decision making before the start of palliative sedation (87.4%) was less frequently present in patients suffering from cardiovascular or chronic obstructive pulmonary disease and in older patients compared to patients with cancer (P<0.05). Pending euthanasia requests were present in 20.8% of cases; the choice for palliative sedation in these cases was clearly motivated.Conclusion Palliative sedation is performed in a small proportion of dying patients in Dutch general practice, without a rise or decline observed from 2005 to 2011. Patients with non-cancer diseases are less frequently involved in decision making than patients with cancer, possibly related to sudden deterioration.