The use of sedative medication in the final 24 hours of life depends on where you are

In 2008 14 community hospices throughout New Zealand contributed to a benchmarking study of the use of opioids and sedatives in the last 24 hours of life. Data was received on about 350 patients. Analysis of the opioid use showed that there was not a significant difference in the dosages prescribed between different institutions. The use of sedative medications is more varied, and the incidence of patients receiving benzodiazepines in their last 24 hours of life ranges from 40% to over 90%.

Guidelines and definitions exist in the literature to inform the prescribing of sedative drugs at the end of Life. Yet it would appear that the use of benzodiazepines is not as uniform as the use of opioids for pain. The differences that appear in the New Zealand experience are compared with the differences that appear internationally, using data from countries such as India and Japan where there is reported a much lower use of benzodiazepines.

This study notes examines the interplay between guidelines, social and institutional cultures, and the prescribing and administering of sedative medications.