Development of a national clinical guideline for artificial hydration therapy for terminally ill patients with cancer.

Abstract

Although differences in physician practices of artificial hydration therapy for terminally ill patients with cancer can cause unnecessary suffering from overhyrdration or underhydration of patients, no clinical guideline is available in Japan. This paper illustrates a summary of a nationwide project to construct a clinical guideline for artificial hydration therapy. The Japanese Society of Palliative Medicine constructed a national multidisciplinary committee to develop a clinical guideline for artificial hydration therapy for terminally ill patients with cancer, using evidence-based and formal consensus-building methods with the Delphi technique. After systematic literature review, three sequential sessions of discussion using the Delphi method, and an external review, a clinical guideline was established. This guideline includes general recommendations, specific recommendations (31 recommendations for medical aspects, 9 recommendations for nursing, and 7 recommendations for ethics), background descriptions, case examples, communication examples, a complete reference list, and structured abstracts of all relevant original articles. The Japanese Society of Palliative Medicine constructed a clinical guideline for artificial hydration therapy for terminally ill patients with cancer, using evidence-based and formal consensus-building methods. The clinical efficacy of this guideline should be tested in the future.