Quantitative and qualitative analysis of the use of the opiates and satisfaction of recruitment standards of Palliative Care.

Measurement of efficacy of the network of Palliative Care and Pain Control in the Local Health Unit No. 7 in Veneto

(Italy).

Authors: Dott. Cosimo De Chirico; Dott. Marco Luciani; Dott.ssa Paola; Dott. Sandro Cinquetti; Dott. Angelo Lino Del Favero.

Local Health Unit n° 7 Veneto (Italy)

Veneto counts 4.948.931 inhabitants

The Local Health Unit n° 7 guarantees medical care and social welfare for 214.048 people

Palliative Care Team

The équipe is composed by:• The general practitioner, who guarantees continuity of care and a good

alliance with the patient and his family;• A committed doctor, trained in palliative care, who facilitates clinical

decision making and communication between the nodes of the network;

• Nurses, trained for the complexity of palliative care;• Psychologist to support the patient and the care givers (family

members or relatives) and the team members (burden of care, burnout).

Palliative Care Network

Palliative Care Team

Home

Family

Patient

Hospital

Welfare

Home assistance

Palliative Care Network

Instituted in 2005 with the task of coordinate palliative home care network.

Since the construction of the hospice will be completed in autumn 2012, all data refer to our home care network experience.

Project of Hospice “Casa Antica Fonte”

Quantitative analysis of the use of major opiates: Defined Daily Dose

Source of data: Servizio Farmaceutico Territoriale ULSS n°7

Quantitative analysis of the use of major opiates: Equivalent doses of Oral Morphine (mg)

Source of data: Pharmaceutical Service Report ULSS n°7

Consumption of Long Acting Major Opiates

Consumption of Short Acting Major Opiates

Long & Short Acting Opiates

49,02%

37,65%

Rough estimate 2011 64%

Beginning of The Opiates Therapy: Way of Administration

Last Molecule Prescribed

Satisfaction Survey 2010

Recruiting

Network Reporting

Clinical and social impact of the network

Death at home in 64% of patients;

92% of Care Time spent at home;

Chemotherapy in the last month of life: 8% Vs 25% in Italian national average

Total hospitalization rate in ULSS7: 2,5 x 1000 inhabitants

Rough estimate cost of daily home care assistance is nearly 60 euro

Principles of The Law 38/2010

Focus on the patient, his family and relatives and the quality of daily living at home;

Palliative Care Team that works on the territory in strict contact with the General Practitioner;

Network to connect social and health services.

Palliative Care Committed Doctor

Palliative Care Team

Home

Family

Patient

Hospital

Welfare

Home assistance

Trainig on the field

Care Alliance with the GP

CRITICAL POINTS, FUTURE CHALLENGES

In 2008 the 43,4% of the patients followed by the Palliative Care Team deceased at the hospital admitted no more than seven days before the death;

Since the autumn of 2012 the hospice will start working ;

We work to be able to take in charge all palliative patients (oncological or not) in next few years.

Thanks For Your Attention

Disclosure Statement of conflict of interest in the context of the subject of this presentationWithin the past 12 months, I or my spouse/partner have had following financial interest/arrangement(s) or affiliation(s)

below.

Affiliation/Financial Relationship Company

• Support for travel Grünenthal Group• Honoraria for lectures ……………………• Honoraria for advisory board activities ……………………• Participation in clinical trials ……………………• Research funding ……………………• Financial shares and options ……………………• …………………………….. ……………………