Palliative care needs in advanced chronic illness

• Published in: Medicina (Buenos Aires) Vol. 76; no. 3; pp. 139 - 147
• Main Authors: Tripodoro, Vilma A, Rynkiewicz, María C, Llanos, Victoria, Padova, Susana, De Lellis, Silvina, De Simone, Gustavo
• Format: Journal Article
• Language: Spanish
• Published: Argentina 2016
• Subjects: Adolescent; Adult; Age Distribution; Aged; Aged, 80 and over; Argentina - epidemiology; Chronic Disease - epidemiology; Chronic Disease - therapy; Comorbidity; Disease Progression; Female; Health Services Needs and Demand; Hospitals, General - statistics & numerical data; Humans; Male; Middle Aged; Needs Assessment - statistics & numerical data; Palliative Care - methods; Palliative Care - statistics & numerical data; Patient Care Planning; Severity of Illness Index; Sex Distribution; Surveys and Questionnaires; Young Adult; prevalence; palliative approach; chronic disease; public health
• ISSN: 0025-7680

About 75% of population will die from one or more chronic progressive diseases. From this projection WHO urged countries to devise strategies for strengthening palliative treatment as part of comprehensive care. In Catalonia, Spain, direct measurement of the prevalence of these patients with NECPAL CCOMS-ICO© tool was 1.5% of the population. This tool is an indicative, not dichotomous, quali-quantitative multifactorial evaluation to be completed by the treating physician. In Argentina there is no information on these patients. Our goal was to explore and characterize the proportion of chronically ill patients in palliative care needs, by NECPAL CCOMS-ICO© tool, in an accessible population of the City of Buenos Aires. General hospitals of the Health Region 2 (Piñero, álvarez and Santojanni) and its program areas were surveyed. In Health Region 1, we surveyed the Udaondo gastroenterology hospital. A total of 53 physicians (704 patients) were interviewed. It was identified that 29.5% of these patients were affected by advanced chronic diseases; 72.1% of them were NECPAL positive, younger (median 64) than in others studies, and more than 98% presented high levels of comorbidity. Palliative care demand (31.4%) and needs (52.7%) were recorded. Specific indicators of fragility, progression, severity and kind of chronic disease were described. The main finding was to identify, with an instrument not based on mortality that, in Buenos Aires City, 1 in 3 patients with chronic diseases could die in the next year and had palliative care needs.