1436P - Survey on models of integration of oncology and palliative care (PC) in Italian oncology units ESMO designated centers

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Palliative Care
Presenter Vittorina Zagonel
Authors V. Zagonel1, C. Mastromauro2, M. Ciaparrone3, V. Franciosi4, L. Verna5, C. Moro6, Z.C. Di Rocco7, A.A. Martoni8, L. Cavanna9, G. Farina10
  • 1Department Of Oncology, TASK FORCE CONTINUITY OF CARE, 35128 - PADOVA/IT
  • 2TASK FORCE CONTINUITY OF CARE, VENEZIA/IT
  • 3Medical Oncology, TASK FORCE CONTINUITY OF CARE, ROMA/IT
  • 4TASK FORCE CONTINUITY OF CARE, PARMA/IT
  • 5Italian Association Of Medical Oncology, TASK FORCE CONTINUITY OF CARE, L'AQUILA/IT
  • 6Italian Association Of Medical Oncology, TASK FORCE CONTINUITY OF CARE, BERGAMO/IT
  • 7Italian Association Of Medical Oncology, TASK FORCE CONTINUITY OF CARE, ROMA/IT
  • 8Italian Association Of Medical Oncology, TASK FORCE CONTINUITY OF CARE, BOLOGNA/IT
  • 9Oncology Hematology Department, TASK FORCE CONTINUITY OF CARE, PIACENZA/IT
  • 10Italian Association Of Medical Oncology, TASK FORCE CONTINUITY OF CARE, MILANO - ON BEHALF OF TASK FORCE CONTINUITY OF CARE IN ONCOLOGY - ITALIAN ASSOCIATION OF MEDICAL ONCOLOGY (AIOM)/IT

Abstract

Background

The early integration of cancer treatment and palliative care (PC) is effective but the current state of integration in Italian Cancer Centers is unknown.

Aims

To determine the models of integration of PC in Italian Oncology Units ESMO Designated Centers of Integrated Oncology and Palliative Care (ESMO-DCs).

Methods

A questionnaire was sended by e-mail to the executives of the 20 Italian ESMO-DCs.

Results

Twenty questionnaires were sent with a response rate of 100%. The geographical distribution of the ESMO-DCs is unbalanced: 12 (60%) in North-Italy, 6 (30%) in the Center, 2 (10%) in the Islands and none in the South. The ESMO-DCs organization is oriented to integration of PC through at least one oncologist oriented to PC in 18 (90%) Centers; guidelines (LG) of symptomatic treatment in 18 (90%); PC beds in 14 (70%) and PC offices in 14 (70%). The name “PC office” is used only in 4/14 (29%) centers; in 10 (71%) Centers alternative names were chosen. ESMO-DCs showed a good integration with Home Care (HC): in 9 (45%) Centers HC is managed by Palliative Care Physicians (PCPs); in 6 (30%) by General Practitioners (GPs); in 3 (15%) by oncologists and in 2 (10%) by PCPs with GPs. When HC is not directly managed by oncologists, the ESMO-DCs achieve the integration through home visits in 6/17 (35%), meetings and/or GL sharing with PCPs and GPs in 11/17 (65%) and 6/17 (35%), respectively. The ESMO-DCs showed a good integration with the Hospices (Hs): in 14 (79%) Centers Hs are managed by PCPs; in 2 (11%) by PCPs with GPs, in 1 (5%) by GPs and in 1(5%) by oncologists. When Hs are not directly managed by oncologists the ESMO-DCs achieve the integration through hospice visits in 7/17(41%), meetings and GL sharing with PCPs and GPs in 11/17 (65%) and 7/17 (41%), respectively. The integration model of reference for 15/20 (75%) ESMO-DCs is Integrated Care Model (see E.Bruera. JCO 2010).

Conclusions

ESMO-DCs are not representative of Italian situation and lack in the South of Italy. The Integrated Care model of ESMO-DCs is Simultaneous Care-oriented but its achievement is different by Center. The “ESMO-DCs” experience is challenging for Oncology Units to improve early integration of palliative care, continuity and quality of assistance of cancer patients.

Disclosure

All authors have declared no conflicts of interest.