Cancer, Chronic Obstructive Pulmonary Disease, Chronic Renal Failure, Idiopathic Pulmonary Fibrosis
Conditions
Keywords
palliative care, appropriateness, cancer, chronic pulmonary failure, chronic renal failure
Brief summary
This is a prospective observational study done on 3 patient populations (cancer, chronic pulmonary and renal disease). All patients will be treated and monitored according to the local clinical practice. No additional procedures/patient visits in comparison with the usual clinical practice are planned for the study.
Detailed description
This is a prospective observational study done on 3 patient populations (cancer, chronic pulmonary and renal disease). All patients will be treated and monitored according to the local clinical practice. No additional procedures/patient visits in comparison with the usual clinical practice are planned for the study. The primary objective is to analyze appropriateness and timeliness of progressive palliative care approach (initially simultaneously with ongoing disease-oriented treatment and subsequently possibly as the only modality of care to avoid aggressiveness of care) in patients with: * First diagnosis of advanced metastatic non-small cell lung cancer, or advanced gastric cancer or advanced pancreatic adenocarcinoma * advanced chronic respiratory failure, caused by chronic obstructive pulmonary disease (COPD) or idiopathic pulmonary fibrosis (IPF). * advanced chronic renal failure
Interventions
As this study is intended to be observational (not interventional), the patient's medical record will be the source of all data to be recorded. No additional procedures/patient visits should be planned in the study with respect to clinical practice. Two tools will be used to to analyze appropriateness and timeliness of progressive palliative care approach: NECPAL CCOMS-ICO(©), specific for the assessment of needs in palliative care, and the PaP score, for the assessment of prognosis.
Sponsors
Study design
Eligibility
Inclusion criteria
* Both sex; * All ethnic background; * Age ≥18 years; * Subjects who are, in the opinion of the Investigator, able to understand this study and to cooperate with the study procedures; * Written informed consent; * Not receiving care from the palliative care service Inclusion Criteria specific for POPULATION A: * Diagnosis of inoperable locally advanced and/or metastatic non-small cell lung cancer, or gastric cancer or pancreatic adenocarcinoma within the previous eight weeks, any T, any N, M+ or T4 inoperable (neoadjuvant excluded); * Life expectancy \>2 months; Inclusion Criteria specific for POPULATION B: * Diagnosis of chronic obstructive pulmonary disease (COPD) with at least two of these characteristics: age \> 70 years, FEV1 \<30 % predicted, oxygen-therapy dependency, \> 1 admission/year in hospital for COPD exacerbated, congestive heart failure and/or other comorbidity, weight loss/cachexia, reduced functional autonomy, increase dependence. * or idiopathic pulmonary fibrosis (IPF) diagnosis with at least two of these characteristics: age \> 70 years, histological pattern UIP (if known), dependence on oxygen-therapy, radiological aspect of Honeycomb to the HRTC of the thorax, reduced functional autonomy, increased dependence. Inclusion Criteria specific for POPULATION C: \- Diagnosis advanced chronic renal failure with at least two of these characteristics: age \> 75 years, advanced malignancy, severe malnutrition, cardiac or pulmonary pathology terminal, Multiple Organ Failure in Intensive Care.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Evaluating PaP (Palliative Prognostic) and NECPAL CCOMS-ICO(©) scores to analyze the appropriateness of progressive palliative care approach | 55 months | Initially simultaneously with ongoing disease-oriented treatment and subsequently as the only modality of care to avoid aggressiveness of care. |
| Evaluating PaP (Palliative Prognostic) and NECPAL CCOMS-ICO(©) scores to analyze timeliness of progressive palliative care approach | 55 months | Initially simultaneously with ongoing disease-oriented treatment and subsequently as the only modality of care to avoid aggressiveness of care. |
Countries
Italy