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Opioids efficiently manage pain and dyspnea. However, guidelines on symptom management with opioids differ, which may lead to uncertainty among medical staff concerning opioid indication and ethical implication, especially when caring for COVID-19 patients.We aimed to examine the perception of morphine/opioid (M/O) administration for symptom control within and outside palliative care, including care for COVID-19 patients, among members of the German associations for palliative medicine, internal medicine, anesthesiology and intensive care.Participants received an anonymized online questionnaire via Survey Monkey® (Momentive Inc., San Mateo, CA, USA) regarding their general perception of symptom management with M/O. These results have been published elsewhere. For systematic and structural analysis of comments in the free-text field, we chose Phillip Mayring's method of summarizing qualitative content analysis.Of the n = 2202 persons who participated, 339 wrote comments in the free-text field which were categorized as follows: main categories 1) personal perceptions of COVID-19 patients, 2) administration and effect of M/O, 3) observations within the palliative care field, 4) imparting knowledge concerning M/O usage and palliative care, and 5) others.Some participants reported very personal perceptions and deficits of the healthcare system, especially when caring for COVID-19 patients. Uniform interdisciplinary guidelines for symptom control, more education, and support by trained staff confident in symptom control should be increasingly considered in the future.HINTERGRUND: Obwohl Opioide wirksam Schmerzen und Dyspnoe lindern, findet dies in Leitlinien zur Symptomkontrolle unterschiedliche Gewichtung. Hierdurch können auch bei COVID-19 Unsicherheiten bezüglich Indikationen und ethischer Implikationen im Umgang mit Opioiden entstehen.Wir untersuchten die persönliche Wahrnehmung des Umgangs mit Morphin/Opioiden (M/O) zur Symptomkontrolle inner- und außerhalb der Palliativmedizin (PM), auch bei der Betreuung COVID-19-Erkrankter, durch Befragung von Mitgliedern der Fachgesellschaften für Palliativmedizin, Innere Medizin, Anästhesiologie und Intensivmedizin.Mittels Survey Monkey® (Momentive Inc., San Mateo, CA, USA) wurden die Mitglieder anonymisiert nach ihrer eigenen Wahrnehmung des Umgangs mit M/O zur Symptomkontrolle befragt. Diese Ergebnisse wurden bereits publiziert. Zur systematischen und strukturierten Auswertung aller Kommentare des Freitextfelds wurde Phillip Mayrings Methode der zusammenfassenden qualitativen Inhaltsanalyse gewählt.Von 2202 Personen schrieben 339 im Freitextfeld „Weitere Anmerkungen“ zusätzliche Kommentare. Das induktiv entwickelte Kategoriensystem umfasste fünf Hauptkategorien: 1) Eigene Wahrnehmungen mit COVID-19-Erkrankten, 2) Anwendungsgebiet und Wirkung von M/O, 3) Beobachtungen im Bereich der Palliativmedizin, 4) Vermittlung von Wissen zum Umgang mit Opioiden bzw. Palliativmedizin, und 5) Ergänzendes.Einige Teilnehmende berichteten sehr persönliche Wahrnehmungen und wiesen insbesondere im Umgang mit COVID-19 auf Defizite im Gesundheitssystem hin. Einheitliche interdisziplinäre Leitlinien zur Symptomkontrolle, mehr Lehre und Unterstützung durch in der Symptomkontrolle kompetente Expert:innen erscheinen erforderlich.

BMC palliative care 21(1), 10 (2022). doi:10.1186/s12904-021-00898-w, Published by BioMed Central, London

​IntroductionRandomised controlled trials (RCTs) have shown a positive effect of early integration of palliative care (EIPC) in various advanced cancer entities regarding patients’ quality of life (QoL), survival, mood, caregiver burden and reduction of aggressiveness of treatment near the end of life. However, RCTs investigating the positive effect of EIPC for patients suffering from glioblastoma multiforme (GBM) are lacking. After modelling work identifying the specific needs of GBM patients and their caregivers, the aim of this study is to investigate the impact of EIPC in this particular patient group.​Methods and analysisThe recruitment period of this multicenter RCT started in May 2019. GBM patients (n=214) and their caregivers will be randomly assigned to either the intervention group (receiving proactive EIPC on a monthly basis) or the control group (receiving treatment according to international standards and additional, regular assessment of QoL (‘optimised’ standard care)).The primary outcome is QoL assessed by subscales of the Functional Assessment of Cancer Therapy for brain tumour (FACT-Br) from baseline to 6 months of treatment. Secondary outcomes are changes in QoL after 12 (end of intervention), 18 and 24 months (end of follow-up), the full FACT-Br scale, patients’ palliative care needs, depression/anxiety, cognitive impairment, caregiver burden, healthcare use, cost-effectiveness and overall survival.​Ethics and disseminationThe study will be conducted in accordance with the Declaration of Helsinki and has been approved by the local ethics committees of the University Clinics of Cologne, Aachen, Bonn, Freiburg and Munich (LMU). Results of the trial will be submitted for publication in a peer-reviewed, open access journal and disseminated through presentations at conferences.Trial registration numberGerman Register for Clinical Studies (DRKS) (DRKS00016066); Pre-results.

Additional file 2 Questionnaire Round 0 for patients.

Additional file 1 Questionnaire Round 0 for medical professionals.