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. 2022 May 23;14(10):2568.
doi: 10.3390/cancers14102568.

Simultaneous Care in Oncology: A 7-Year Experience at ESMO Designated Centre at Veneto Institute of Oncology, Italy

Antonella Brunello  1 , Antonella Galiano  1 , Stefania Schiavon  2 , Mariateresa Nardi  3 , Alessandra Feltrin  4 , Ardi Pambuku  2 , Chiara De Toni  1 , Alice Dal Col  2 , Evelina Lamberti  1 , Chiara Pittarello  1 , Francesca Bergamo  1 , Umberto Basso  1 , Marco Maruzzo  1 , Silvia Finotto  1 , Maital Bolshinsky  1 , Silvia Stragliotto  5 , Letizia Procaccio  1 , Mario Domenico Rizzato  1 , Fabio Formaglio  2 , Giuseppe Lombardi  1 , Sara Lonardi  5 , Vittorina Zagonel  1
Affiliations

Simultaneous Care in Oncology: A 7-Year Experience at ESMO Designated Centre at Veneto Institute of Oncology, Italy

Antonella Brunello et al. Cancers (Basel). .

Abstract

Benefits of early palliative care referral in oncology are well-validated. At the Veneto Institute of Oncology-IRCCS, a simultaneous-care outpatient clinic (SCOC) has been active since 2014, where patients with advanced cancer are evaluated by an oncologist together with a palliative care team. We prospectively assessed SCOC patients’ characteristics and SCOC outcomes through internal procedure indicators. Data were retrieved from the SCOC prospectively maintained database. There were 753 eligible patients. The median age was 68 years; primary tumor sites were gastrointestinal (75.2%), genitourinary (15.0%) and other sites (9.8%). Predominant symptoms were psychological issues (69.4%), appetite loss (67.5%) and pain (65.9%). Dyspnea was reported in 53 patients (7%) in the referral form, while it was detected in 226 patients (34.2%) during SCOC visits (p < 0.0001). Median survival of patients after the SCOC visit was 7.3 months. Survival estimates by the referring oncologist were significantly different from the actual survival. Psychological intervention was deemed necessary and undertaken in 34.6% of patients, and nutritional support was undertaken in 37.9% of patients. Activation of palliative care services was prompted for 77.7% of patients. Out of 357 patients whose place of death is known, 69.2% died at home, in hospice or residential care. With regard to indicators’ assessment, the threshold was reached for 9 out of 11 parameters (81.8%) requested by the procedure. This study confirmed the importance of close collaboration between oncologists and palliative care teams in responding properly to cancer patients’ needs. The introduction of a procedure with indicators allowed punctual assessment of a team’s performance.

Keywords: advanced disease; early palliative care; indicators of integration; simultaneous care; symptom control.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure A1
Figure A1
Simultaneous-care referral form.
Figure A2
Figure A2
Comparison of symptoms recorded in referral form and during SCOC visit.
Figure A3
Figure A3
Symptom severity among patients, according to ESAS. Bars represent the absolute frequencies of symptoms grouped by three levels of severity. The number of patients for whom individual ESAS scores were available ranged from 661 to 675.
Figure 1
Figure 1
Patient journey.
Figure 2
Figure 2
Flow chart of the study.
Figure 3
Figure 3
Comparison between actual and estimated survival.
Figure 4
Figure 4
Enrollment of patients according to referral form score and year of referral.
Figure 5
Figure 5
Pie chart of place of death. Data available for 357 subjects.
See this image and copyright information in PMC

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