Position Paper of the Italian Association of Medical Oncology on Early Palliative Care in Oncology Practice (Simultaneous Care)

Zagonel, Vittorina; Franciosi, Vittorio; Brunello, Antonella; Biasco, Guido; Broglia, Chiara; Cattaneo, Daniela; Cavanna, Luigi; Corsi, Domenico; Farina, Gabriella; Fioretto, Luisa; Gamucci, Teresa; Lanzetta, Gaetano; Magarotto, Roberto; Maltoni, Marco; Marchetti, Paolo; Massa, Elena; Mastromauro, Cataldo; Melotti, Barbara; Meriggi, Fausto; Nacci, A.; Pavese, Ida; Piva, Erico; Quirino, Michela; Roselli, Mario; Sacco, Cosimo; Tonini, Giuseppe; Trentin, Livio; Ucci, G.; Labianca, Roberto; Gori, Stefania; Pinto, Carmine; Cascinu, Stefano; Simultaneous, Aiom; Care, Task Force: Esmo Italian DCs Continuous

doi:10.5301/tj.5000593

Cited by 15 publications

(12 citation statements)

References 44 publications

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“…In 2006, the Italian Association of Medical Oncology (AIOM), according to the ESMO program, set up the Simultaneous and Continuous Care (SCC) Task Force with the main goals of training oncologists in palliative medicine and spreading the culture of integration between oncologists and palliative care teams in every oncology unit in Italy [45]. …”

Section: Discussionmentioning

confidence: 99%

“…The European Society for Medical Oncology (ESMO) has been leading the way since 2003 by formally accrediting Designated Centers of Integrated Oncology and Palliative Care (ESMO-DCs). In 2006, the Italian Association of Medical Oncology (AIOM), according to the ESMO program, set up the Simultaneous and Continuous Care (SCC) Task Force with the main goals of training oncologists in palliative medicine and spreading the culture of integration between oncologists and palliative care teams in every oncology unit in Italy [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

“…Such a simultaneous approach requires a cultural change in oncologists, and several organizational barriers can hinder the efforts of individual operators. As highlighted in the document-derived recommendations, early activation of palliative care concomitant to cancer-directed treatment in the setting of advanced/metastatic disease is considered one of the top priorities by the community of Italian medical oncologists [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

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Can early palliative care with anticancer treatment improve overall survival and patient-related outcomes in advanced lung cancer patients? A review of the literature

Ambroggi

Biasini

Toscani

et al. 2018

Support Care Cancer

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PurposeMetastatic non-small-cell lung cancer (NSCLC), the leading cause of death from cancer worldwide, is a debilitating disease that results in a high burden of symptoms and poor quality of life; the estimated prognosis after the diagnosis has been established was less than 1 year until some years ago. At the present, the new targeted therapies and immunotherapy are changing the course of the disease. However, advanced NSCLC remains an incurable disease, with a poor prognosis for the majority of the affected patients, so that quality of life and relief from symptoms are primary objectives of treatment. Some evidences suggest that early palliative care (EPC) for these patients can improve quality of life and even survival.DesignA systematic review of the studies evaluating the impact on objective and on patient-reported outcomes of the introduction of EPC in opposition to standard care (SC), for advanced lung cancer patients, was performed. Because of the small number of studies conducted in this area, retrospective studies were also considered for the review.ResultsFive studies were included because they matched the inclusion criteria previously defined as relevant for the study. The review found that both survival and quality of life were better for patients included in EPC groups.ConclusionsWhile results of the studies included in this review are not always comparable because different methods and scales have been used, there is enough evidence for clinical oncologists to implement the use of EPC in clinical practice for advanced lung cancer patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Can early palliative care with anticancer treatment improve overall survival and patient-related outcomes in advanced lung cancer patients? A review of the literature

Ambroggi

Biasini

Toscani

et al. 2018

Support Care Cancer

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“…AIOM recently published a position paper on early palliative care in oncology practice (simultaneous care) with the following recommendations: “highlight the role of skills and competence in palliative care along with implementation of adequate organizational models to accomplish simultaneous care, which is considered a high priority in order to grant the best quality of life for cancer patients and their families.” 41…”

Section: Early Palliative Care: Which Models?mentioning

confidence: 99%

Consensus document of the Italian Association of Medical Oncology and the Italian Society of Palliative Care on early palliative care

Corsi

Turriziani

Cavanna

et al. 2018

Tumori

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A consensus document on early palliative care was produced by a committed Working Group of the Italian Society of Medical Oncology and the Italian Society of Palliative Care to improve the early integration of palliative care in medical oncology and to stimulate and guide the choices of those who daily face the problems of advanced stage cancer patients. The simultaneous administration of antineoplastic treatments and early palliative care was shown to be beneficial in metastatic cancer pathway outcomes. Patients who could benefit from early palliative care are those with an advanced cancer at presentation, a compromised PS for cancer, and/or morbidities, and who are too frail to receive treatment. According to the Bruera practice models, in which the combination of cancer management with early palliative care can be offered, three groups of patients needing simultaneous care were identified and three different models of the delivery of palliative care were proposed. In patients with good prognosis and low need of simultaneous care, the solo practice model and the request for consultations were suggested, while in patients with poor prognosis disease with high need of simultaneous care and in conditions with high need of simultaneous care, regardless of cancer prognosis, the integrated care approach should be offered. Palliative care consultation services are seldom accessible in the majority of Italian hospitals; thus the application of various practice models depends on available resources, and a shared care model with the structures of palliative care operating in the area is often required.

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“…International scientific societies recommend early interaction between oncologic and palliative care as one of the most important tasks of modern oncology practice (Zagonel et al, 2017; Ferrel et al, 2017; Davis et al, 2015). Some recent clinical trials and literature reviews showed that early integration of palliative care could improve the quality of life of patients with cancer and symptom management, but the impact on survival still remains a matter of debate (Davis et al, 2015; Bakitas et al, 2015; Temel et al, 2010; Haun et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

The PERSONS score: A new tool for cancer patients’ symptom assessment in simultaneous care and home care settings

et al. 2019

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BackgroundScientific societies recommend early interaction between oncologic and supportive care, but there is still a lack of systematic evaluations regarding symptoms from the perspective of oncologists.Patients and methodsThe aim of this prospective study was to evaluate the PERSONS score, in both “simultaneous care” and “supportive care” settings using the Edmonton Symptom Assessment Scale (ESAS) as a comparator.ResultsFrom November 2017 to April 2018, 67 and 110 consecutive patients were enrolled in outpatient and home care cohorts, respectively. The final study population comprised 163 patients. There were no significant changes over time in the total PERSONS scores and total ESAS scale. The intra-interviewer reliability (ICC2,1) and inter-interviewer reliability (ICC2,k) showed good reproducibility (test-retest) in each group of patients: 0.60 (0.49–0.70) and 0.82 (0.75–0.87), respectively, for the home care patients and 0.73 (0.62–0.81) and 0.89 (0.83–0.93), respectively, for the outpatient cohort. There were high correlations between PERSONS and ESAS, both at the baseline and final assessments. The mean PERSONS and ESAS scores between the home care patients and outpatients were not different at the baseline and final assessments. Receiver operating characteristics (ROC) curve for the PERSONS total score revealed good diagnostic ability. Area under the curve (AUC) was 0.825 and 0.805 for improvement and deterioration, respectively.ConclusionsThe PERSONS score is an easy to apply tool for symptom assessment. Importantly, the PERSONS score showed high concordance with the established ESAS scale and, therefore, provides an alternative for everyday use in supportive care assessment.

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Position Paper of the Italian Association of Medical Oncology on Early Palliative Care in Oncology Practice (Simultaneous Care)

Cited by 15 publications

References 44 publications

Can early palliative care with anticancer treatment improve overall survival and patient-related outcomes in advanced lung cancer patients? A review of the literature

Can early palliative care with anticancer treatment improve overall survival and patient-related outcomes in advanced lung cancer patients? A review of the literature

Consensus document of the Italian Association of Medical Oncology and the Italian Society of Palliative Care on early palliative care

The PERSONS score: A new tool for cancer patients’ symptom assessment in simultaneous care and home care settings

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