Don’t propose any type of palliative chemotherapy in the end-of-life setting.
The results of numerous prospective clinical studies indicate that chemotherapy administered to patients with metastatic cancer in their last 30 days of life is ineffective and leads, particularly in the last week of life, to an increased utilization of intensive care...
Don’t use costly drugs when low-cost generics with the same composition are available and try to convey a correct information to citizens on this point.
Generic drugs have the same composition as branded drugs and possess similar effectiveness, but their cost is 30 to 70% lower. In Italy, the increased use of generics from 2010 al 2014 (+55% as DDD/1000 inhabitants/day) has determined a saving in the pharmaceutical...
Do not postpone the start of a shared care planning with the patient, when the evolution of the disease makes it important to understand the expectations and desires of the sick person regarding possible choices at the end of life.
Shared planning of care is provided for by Law 219/2017 “Rules on Informed Consent and Advance Treatment Provisions”. It allows the sick person, if desired, and the treating physician to align themselves on the goals of care, on futile or disproportionate...
When organizing a local palliative care network, don’t omit the activation of II° level home care involving medical staff (doctors and nurses) with specialised training palliative care and team management.
As highlighted by a recent systematic review, the intervention of specialized multi-professional palliative care teams in the home is better for ensuring effective symptom management and supporting patient death at home than the more “traditional”...The campaign DOING MORE DOES NOT MEAN DOING BETTER – CHOOSING WISELY ITALY is promoted by Italy’s Slow Medicine
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