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...
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.The campaign DOING MORE DOES NOT MEAN DOING BETTER – CHOOSING WISELY ITALY is promoted by Italy’s Slow Medicine
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