ABSTRACT
. The need for palliative care in home care patients. Prospective observational study with the implementation of two algorithms. INTRODUCTION: The early identification of patients with palliative care needs is crucial for defining appropriate care settings and interventions. OBJECTIVE: To detect the need for palliative care in home care patients and to compare two instruments: the SPICT™ and the I-CURPAL-029. METHODS: All new patients taken on in home care in the South-West and North-West Districts of the ASL Città di Torino between 27/12/2021 and 19/02/2022 were included and assessed with the two systems at intake, at two and six weeks. Data collected on patients: demographic characteristics, diagnosis, reason and duration of admission, reason for discharge, degree of autonomy and mobility, presence of cognitive and behavioural disorders, social support. RESULTS: 170 patients were included. At admission, 99 (58.2%) patients with SPICT™ and 84 (49.4%) with I-CURPAL-029 were assessed as needing palliative care; 78 (45.9%) by both instruments. Of the 13 with a need for specialist palliation, 8 were transferred to specialist palliative care. Changes in patients' conditions between controls were detected by both instruments and only affected 12.4% of the sample. SPICT™ and I-CURPAL-029 were sensitive in detecting the need for palliation. SPICT™ was suitable for the home context due to the presence of indicators on caregiving. CONCLUSIONS: Many patients in home care need palliative care. To support decisions for specialistic care, patients classified as palliative by SPICT™ could be assessed with I-CURPAL-029 to identify the need for specialist palliative care.
