The need for palliative care in home care patients.Prospective observational study with the implementation of two algorithms

The early identification of patients with palliative care needs is crucial for defining appropriate care settings and interventions. Objective. To de-tect the need for palliative care in home care patients and to compare two instruments: the SPICT™ and the I-CUR-PAL-029. Methods. All new patients taken on in home care in the South-West and North-West Districts of the ASL Cit-tà 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 ad-mission, 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 con-trols 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 special-istic care, patients classified as palliative by SPICT™ could be assessed with I-CURPAL-029 to identify the need for specialist palliative care.