Therapieempfehlungen zum Off-Label-Use palliativmedizinisch relevanter Arzneistoffe: alternative Applikationsarten – Konsentierung durch Delphi-Verfahren

Zusammenfassung

Der Off-Label-Use (OLU) von Arzneimitteln gehört zum Alltag in der Palliativversorgung. Neben abweichenden Indikationen betrifft dies auch alternative Applikationswege. Die Arzneimitteltherapiesicherheit ist neben Aufklärung und Haftung zu berücksichtigen. Im Alltag fehlen häufig Zeit und Ressourcen für Literaturrecherche und Evidenzbewertung.
Ziel ist die Erstellung und Konsentierung von Therapieempfehlungen zum OLU von Arzneimitteln in der Palliativversorgung sowie deren Veröffentlichung auf der Webseite „pall-OLU.de“.
Nach einem systematischen Vorgehen wurden relevante Wirkstoffe und OLU-Applikationen ausgewählt und Empfehlungen auf Basis der bestverfügbaren Evidenz erarbeitet. Eine Runde aus 60–76 Expert:innen bewertete diese in vier Online-Delphi-Verfahren.
45 der konsentierten Therapieempfehlungen betrafen die Applikationsart als OLU von 21 Wirkstoffen.
Mit Veröffentlichung der Therapieempfehlungen auf pall-OLU.de steht Fachkräften erstmals eine Datenbank mit Informationen zum OLU von Arzneimitteln in der Palliativversorgung zur Verfügung.

Abstract

Off-Label-Use (OLU) of drugs is part of everyday practice in palliative care. In addition to deviating indications, this also applies to alternative routes of administration. Patient information, liability and safety of drug therapy must be considered. There is often a lack of time and resources for literature research and evaluation of evidence in clinical practice.
The aim of this project is to develop and rate agreement on treatment recommendations for the OLU of drugs in palliative care and their publication on the website “pall-OLU.de”.
By a systematic approach, relevant drugs and OLU applications were selected and recommendations were developed based on the best available evidence. An expert panel consisting of 60–76 experts evaluated these recommendations in four Delphi studies.
45 treatment recommendations concerned the route of administration as OLU of 21 substances.
With publication of the treatment recommendations on pall-OLU.de, a database with information regarding OLU of drugs in palliative care is available to healthcare professionals for the first time.

Schlüsselwörter

Off-Label-Use - Palliativversorgung - Delphi-Verfahren - Arzneimitteltherapiesicherheit - Applikationsarten

Keywords

off-label-use - palliative care - Delphi technique - drug safety - drug application

Publication History

Received: 10 June 2025

Accepted after revision: 22 July 2025

Article published online:
14 August 2025

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