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Evidence summaries

Medically Assisted Hydration for Adults Receiving Palliative Care

There is insufficient evidence to either support or refute the use of medically assisted hydration for adults receiving palliative care to improve quality of life or survival. Level of evidence: "D"

A Cochrane review [Abstract] 1 included 4 studies with a total of 422 adult palliative care patients. All participants had a diagnosis of advanced cancer.

Medically assisted hydration (MAH) compared with placebo: Quality of life (QoL) measured by Cancer Therapy - General (FACT-G; scale from 0 to 108; higher score = better QoL): no statistically significant difference was observed (MD 4.10, 95% CI 1.63 to 9.83; 1 study,n=93).One study reported on intensity of adverse events at 2 days using a numeric rating scale (scale from 0 to 10; lower score = less toxicity). No statistically significant difference was observed (injection site pain MD 0.35, 95% CI 1.19 to 1.89; injection site swelling MD 0.59, 95% CI 1.40 to 0.22; 1 study, n=49).

MAH compared with standard care:No data were available for QoL.One study measured survival from randomisation to last date of follow-up at 14 days or death. The reported HR for survival at 3 days in the MAH group was 0.36 (95% CI 0.22 to 0.59; 1 study, n=200). It was uncertain whether MAH leads to adverse events (RR 11.62, 95% CI 1.62 to 83.41; 2 studies, n=242).

Comment: The quality of evidence is downgraded by imprecise results (limited study size for each comparison), by indirectness (studies only included participants with advanced cancer), and by study limitations (lack of blinding).

    References

    • Buchan EJ, Haywood A, Syrmis W, ym. Medically assisted hydration for adults receiving palliative care. Cochrane Database Syst Rev 2023;12(12):CD006273 [PubMed]

Primary/Secondary Keywords