Supportive Care in Cancer

, Volume 21, Issue 4, pp 935–939

Pattern and characteristics of advanced cancer patients admitted to hospices in Italy

Authors

    • Pain Relief and Palliative Care UnitLa Maddalena Cancer Center
    • Department of Palliative MedicineUniversity of Palermo
  • Alessandro Valle
    • Hospice FARO
  • Silvana Sabba
    • Hospice ASL TO4
  • Antonio Orlando
    • Hospice Casa dei Gelsi
  • Francesca Guolo
    • Hospice Casa dei Gelsi
  • Loretta Gulmini
    • Hospice “Le onde e il mare”
  • Sara Ori
    • Hospice “Le onde e il mare”
  • Rosanna Bellingardo
    • Pain Relief and Palliative Care UnitLa Maddalena Cancer Center
    • Department of Palliative MedicineUniversity of Palermo
  • Alessandra Casuccio
    • Department of Clinical NeuroscienceUniversity of Palermo
Original Article

DOI: 10.1007/s00520-012-1608-3

Cite this article as:
Mercadante, S., Valle, A., Sabba, S. et al. Support Care Cancer (2013) 21: 935. doi:10.1007/s00520-012-1608-3

Abstract

The aim of this multicenter study was to assess the pattern and the characteristics of advanced cancer patients admitted to hospices. A consecutive sample of patients admitted in a period of 6 months was taken into consideration. Two hundred thirty-six patients admitted to hospices were consecutively assessed. Ninety-six percent of patients were admitted in acute hospital in the previous 3 months, with a mean time spent in hospital of 34.5 days, and 47 % of patients had received chemotherapy the month before hospice admission. Thirty-four percent of patients for whom data were available had significant persistent pain, and 44 % of them presented episodes of breakthrough pain. Sixty-one percent of patients were receiving opioid drugs at admission, and 70 % the day before death, with parenteral morphine and transdermal fentanyl being the opioids most frequently administered. The mean admission time in hospice was 18.4 days. Eighty-six percent died in hospice. Palliative sedation was performed in 25 % of patients who died in hospice. The short survival and the number of patients dying in hospice were the principal finding, as it appears that hospice admission is only one way for end of life treatments. Patients receive specialized palliative care only for 2–3 weeks before death, implying an inacceptable timing for patients with several problems presumed to be present early during the course of disease. Data from hospice activities in Italy strongly suggest to spread palliative care in other settings, other than home care and hospice, to intercept oncologic patients in their disease trajectory early.

Keywords

Palliative care Hospice Advanced cancer

Copyright information

© Springer-Verlag Berlin Heidelberg 2012