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Evidence for the use of Levomepromazine for symptom control in the palliative care setting: a systematic review

BACKGROUND: Levomepromazine is an antipsychotic drug that is used clinically for a variety of distressing symptoms in palliative and end-of-life care. We undertook a systematic review based on the question “What is the published evidence for the use of levomepromazine in palliative symptom control?”...

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Autores principales: Dietz, Isabel, Schmitz, Andrea, Lampey, Ingrid, Schulz, Christian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3602665/
https://www.ncbi.nlm.nih.gov/pubmed/23331515
http://dx.doi.org/10.1186/1472-684X-12-2
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author Dietz, Isabel
Schmitz, Andrea
Lampey, Ingrid
Schulz, Christian
author_facet Dietz, Isabel
Schmitz, Andrea
Lampey, Ingrid
Schulz, Christian
author_sort Dietz, Isabel
collection PubMed
description BACKGROUND: Levomepromazine is an antipsychotic drug that is used clinically for a variety of distressing symptoms in palliative and end-of-life care. We undertook a systematic review based on the question “What is the published evidence for the use of levomepromazine in palliative symptom control?”. METHODS: To determine the level of evidence for the use of levomepromazine in palliative symptom control, and to discover gaps in evidence, relevant studies were identified using a detailed, multi-step search strategy. Emerging data was then scrutinized using appropriate assessment tools, and the strength of evidence systematically graded in accordance with the Oxford Centre for Evidence-Based Medicine’s ‘levels of evidence’ tool. The electronic databases Medline, Embase, Cochrane, PsychInfo and Ovid Nursing, together with hand-searching and cross-referencing provided the full research platform on which the review is based. RESULTS: 33 articles including 9 systematic reviews met the inclusion criteria: 15 on palliative sedation, 8 regarding nausea and three on delirium and restlessness, one on pain and six with other foci. The studies varied greatly in both design and sample size. Levels of evidence ranged from level 2b to level 5, with the majority being level 3 (non-randomized, non-consecutive or cohort studies n = 22), with the quality of reporting for the included studies being only low to medium. CONCLUSION: Levomepromazine is widely used in palliative care as antipsychotic, anxiolytic, antiemetic and sedative drug. However, the supporting evidence is limited to open series and case reports. Thus prospective randomized trials are needed to support evidence-based guidelines.
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spelling pubmed-36026652013-03-21 Evidence for the use of Levomepromazine for symptom control in the palliative care setting: a systematic review Dietz, Isabel Schmitz, Andrea Lampey, Ingrid Schulz, Christian BMC Palliat Care Research Article BACKGROUND: Levomepromazine is an antipsychotic drug that is used clinically for a variety of distressing symptoms in palliative and end-of-life care. We undertook a systematic review based on the question “What is the published evidence for the use of levomepromazine in palliative symptom control?”. METHODS: To determine the level of evidence for the use of levomepromazine in palliative symptom control, and to discover gaps in evidence, relevant studies were identified using a detailed, multi-step search strategy. Emerging data was then scrutinized using appropriate assessment tools, and the strength of evidence systematically graded in accordance with the Oxford Centre for Evidence-Based Medicine’s ‘levels of evidence’ tool. The electronic databases Medline, Embase, Cochrane, PsychInfo and Ovid Nursing, together with hand-searching and cross-referencing provided the full research platform on which the review is based. RESULTS: 33 articles including 9 systematic reviews met the inclusion criteria: 15 on palliative sedation, 8 regarding nausea and three on delirium and restlessness, one on pain and six with other foci. The studies varied greatly in both design and sample size. Levels of evidence ranged from level 2b to level 5, with the majority being level 3 (non-randomized, non-consecutive or cohort studies n = 22), with the quality of reporting for the included studies being only low to medium. CONCLUSION: Levomepromazine is widely used in palliative care as antipsychotic, anxiolytic, antiemetic and sedative drug. However, the supporting evidence is limited to open series and case reports. Thus prospective randomized trials are needed to support evidence-based guidelines. BioMed Central 2013-01-19 /pmc/articles/PMC3602665/ /pubmed/23331515 http://dx.doi.org/10.1186/1472-684X-12-2 Text en Copyright ©2013 Dietz et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Dietz, Isabel
Schmitz, Andrea
Lampey, Ingrid
Schulz, Christian
Evidence for the use of Levomepromazine for symptom control in the palliative care setting: a systematic review
title Evidence for the use of Levomepromazine for symptom control in the palliative care setting: a systematic review
title_full Evidence for the use of Levomepromazine for symptom control in the palliative care setting: a systematic review
title_fullStr Evidence for the use of Levomepromazine for symptom control in the palliative care setting: a systematic review
title_full_unstemmed Evidence for the use of Levomepromazine for symptom control in the palliative care setting: a systematic review
title_short Evidence for the use of Levomepromazine for symptom control in the palliative care setting: a systematic review
title_sort evidence for the use of levomepromazine for symptom control in the palliative care setting: a systematic review
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3602665/
https://www.ncbi.nlm.nih.gov/pubmed/23331515
http://dx.doi.org/10.1186/1472-684X-12-2
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