1The Qualy Observatory/WHO Collaborating Centre for Palliative Care Public Health Programmes (WHOCC), Institut Català d'Oncologia (ICO), Barcelona, Spain.
Palliat Med. 2014 Apr;28(4):302-11. doi: 10.1177/0269216313518266. Epub 2014 Jan 8.
Of deaths in high-income countries, 75% are caused by progressive advanced chronic conditions. Palliative care needs to be extended from terminal cancer to these patients. However, direct measurement of the prevalence of people in need of palliative care in the population has not been attempted.
Determine, by direct measurement, the prevalence of people in need of palliative care among advanced chronically ill patients in a whole geographic population.
Cross-sectional, population-based study.
prevalence of advanced chronically ill patients in need of palliative care according to the NECPAL CCOMS-ICO(©) tool. NECPAL+ patients were considered as in need of palliative care.
SETTING/PARTICIPANTS: County of Osona, Catalonia, Spain (156,807 inhabitants, 21.4% > 65 years). Three randomly selected primary care centres (51,595 inhabitants, 32.9% of County's population) and one district general hospital, one social-health centre and four nursing homes serving the patients. Subjects were all patients attending participating settings between November 2010 and October 2011.
A total of 785 patients (1.5% of study population) were NECPAL+: mean age = 81.4 years; 61.4% female. Main disease/condition: 31.3% advanced frailty, 23.4% dementia, 12.9% cancer (ratio of cancer/non-cancer = 1/7), 66.8% living at home and 19.7% in nursing home; only 15.5% previously identified as requiring palliative care; general clinical indicators of severity and progression present in 94% of cases.
Direct measurement of prevalence of palliative care needs on a population basis is feasible. Early identification and prevalence determination of these patients is likely to be the cornerstone of palliative care public health policies.
在高收入国家，75%的死亡是由进展性的晚期慢性病引起的。姑息治疗需要从晚期癌症扩展到这些患者。然而，尚未尝试直接测量人群中需要姑息治疗的患者的患病率。
通过直接测量，确定整个地理人群中晚期慢性病患者中需要姑息治疗的患者的患病率。
横断面、基于人群的研究。
根据 NECPAL CCOMS-ICO(©)工具，需要姑息治疗的晚期慢性病患者的患病率。NECPAL+患者被认为需要姑息治疗。
设置/参与者：西班牙加泰罗尼亚奥索尼县（156807 名居民，21.4%>65 岁）。随机选择了三个初级保健中心（51595 名居民，占该县人口的 32.9%）和一家地区综合医院、一个社会卫生中心和四家为患者服务的疗养院。研究对象均为 2010 年 11 月至 2011 年 10 月期间在参与机构就诊的患者。
共有 785 名患者（占研究人群的 1.5%）为 NECPAL+：平均年龄=81.4 岁；61.4%为女性。主要疾病/状况：31.3%为晚期虚弱，23.4%为痴呆，12.9%为癌症（癌症/非癌症比例为 1/7），66.8%居住在家中，19.7%居住在疗养院；只有 15.5%之前被确定为需要姑息治疗；94%的病例存在严重程度和进展的一般临床指标。
基于人群的姑息治疗需求患病率的直接测量是可行的。早期识别和确定这些患者的患病率可能是姑息治疗公共卫生政策的基石。
