Don’t initiate or prolong artificial nutrition (enteral or parenteral) in late stage cancer patients with a life expectancy of less than a few weeks and a Performance Status <50.
Currently, there is no evidence from observational or experimental studies showing the effectiveness, in terms of increased survival or improved quality of life, of administering artificial nutrition to end-stage cancer patients with limited life-expectancy and poor...
Don’t combine drugs for which there is no documented evidence of compatibility and chemical and physical stability in devices for the continuous subcutaneous or intravenous infusion of medications (e.g. Elastomers).
In palliative care it is common practice to administer of a combination of drugs by elastomeric pumps for continuous subcutaneous infusion when patients are unable to take oral medication. Due to incompatibility, some combinations may produce chemical-physical...
Don’t exclude nor postpone the oral or parenteral administration of opioids for the palliative treatment of dyspnoea in patients affected by chronic incurable illness with a limited life expectancy.
According to numerous systematic reviews, oral or parenteral opioids are effective in reducing distress caused by breathlessness in patients with advanced or terminal illness.
Don’t ask for the measurement of pancreatic enzymes in people who have no suspicion of acute pancreatic disease and, in the case of suspected acute pancreatitis, don’t ask the associated measure of amylase and lipase.
Pancreatic lipase has diagnostics performances better than amylase, both as sensitivity and specificity and is the only test to request when suspecting acute pancreatitis.The campaign DOING MORE DOES NOT MEAN DOING BETTER – CHOOSING WISELY ITALY is promoted by Italy’s Slow Medicine
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