Simultaneous Care clinic (SCC): A three-year monoinstituional experience.

Abstract

169 Background: Early palliative care has been shown to improve outcomes in pts with advanced cancer. In accordance with ASCO and AIOM recommendations of implementing palliative care early for pts with metastatic cancer along with active cancer treatment a SCC was set up at Istituto Oncologico Veneto (IOV) in Padova since 2014; Methods: Data of pts referred to the SCC from Mar 2014 to Nov 2016 were retrieved from a prospectively maintained database. Data collected included cancer type, status of disease, PS, ongoing oncological treatment, psychological evaluation, social evaluation, nutritional evaluation, activation of home territorial services and/or Palliative Care services, use of other health services after a first visit and place of death; Results: 533 pts were evaluated by a multidisciplinary team. Overall symptom burden was low with baseline symptom scores highest for fatigue, lack of appetite and depression. Nutritional evaluation revealed 224 pts (42%) with nutritional problems, the most frequent being weight loss (n = 121). Psychological distress was present in 185 pts (35%). Social issues were present in 26 pts (5%) and were dealt with activation of social services (n = 9) or volunteer territorial services (n = 8). Patients deemed in need of home care services after the first access to the SCC were 177 (33%) and for these a formal request for Home Care services activation was sent to the Local Health Territorial Unit. After the first visit 141 patients referred to Emergency Room for intervening problems with median time of 41 days. Globally 290 pts (54%) died with 53% of deaths occurring at home. For pts who were receiving active oncological treatment median time from first-visit in the SCC and death was 126 days. We are also evaluating a score for priority for access to SCC; Conclusions: Early integrated SC may be most effective if targeted to the specific needs of each patient population