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