Response and role of palliative care during the COVID-19 pandemic: A national telephone survey of hospices in Italy

TY - JOUR

T1 - Response and role of palliative care during the COVID-19 pandemic

T2 - A national telephone survey of hospices in Italy

AU - Costantini, Massimo

AU - Sleeman, Katherine E.

AU - Peruselli, Carlo

AU - Higginson, Irene J.

PY - 2020/7/1

Y1 - 2020/7/1

N2 - Background: Palliative care is an important component of health care in pandemics, contributing to symptom control, psychological support, and supporting triage and complex decision making. Aim: To examine preparedness for, and impact of, the COVID-19 pandemic on hospices in Italy to inform the response in other countries. Design: Cross-sectional telephone survey, in March 2020. Setting: Italian hospices, purposively sampled according to COVID-19 regional prevalence categorised as high (>25), medium (15–25) and low prevalence (<15) COVID-19 cases per 100,000 inhabitants. A brief questionnaire was developed to guide the interviews. Analysis was descriptive. Results: Seven high, five medium and four low prevalence hospices provided data. Two high prevalence hospices had experienced COVID-19 cases among both patients and staff. All hospices had implemented policy changes, and several had rapidly implemented changes in practice including transfer of staff from inpatient to community settings, change in admission criteria and daily telephone support for families. Concerns included scarcity of personal protective equipment, a lack of hospice-specific guidance on COVID-19, anxiety about needing to care for children and other relatives, and poor integration of palliative care in the acute planning response. Conclusion: The hospice sector is capable of responding flexibly and rapidly to the COVID-19 pandemic. Governments must urgently recognise the essential contribution of hospice and palliative care to the COVID-19 pandemic and ensure these services are integrated into the health care system response. Availability of personal protective equipment and setting-specific guidance is essential. Hospices may also need to be proactive in connecting with the acute pandemic response.

AB - Background: Palliative care is an important component of health care in pandemics, contributing to symptom control, psychological support, and supporting triage and complex decision making. Aim: To examine preparedness for, and impact of, the COVID-19 pandemic on hospices in Italy to inform the response in other countries. Design: Cross-sectional telephone survey, in March 2020. Setting: Italian hospices, purposively sampled according to COVID-19 regional prevalence categorised as high (>25), medium (15–25) and low prevalence (<15) COVID-19 cases per 100,000 inhabitants. A brief questionnaire was developed to guide the interviews. Analysis was descriptive. Results: Seven high, five medium and four low prevalence hospices provided data. Two high prevalence hospices had experienced COVID-19 cases among both patients and staff. All hospices had implemented policy changes, and several had rapidly implemented changes in practice including transfer of staff from inpatient to community settings, change in admission criteria and daily telephone support for families. Concerns included scarcity of personal protective equipment, a lack of hospice-specific guidance on COVID-19, anxiety about needing to care for children and other relatives, and poor integration of palliative care in the acute planning response. Conclusion: The hospice sector is capable of responding flexibly and rapidly to the COVID-19 pandemic. Governments must urgently recognise the essential contribution of hospice and palliative care to the COVID-19 pandemic and ensure these services are integrated into the health care system response. Availability of personal protective equipment and setting-specific guidance is essential. Hospices may also need to be proactive in connecting with the acute pandemic response.

KW - COVID-19

KW - epidemics

KW - health care surveys

KW - hospice care

KW - hospices

KW - palliative care end-of-life care

KW - pandemics

KW - severe acute respiratory syndrome coronavirus 2

UR - http://www.scopus.com/inward/record.url?scp=85083800310&partnerID=8YFLogxK

U2 - 10.1177/0269216320920780

DO - 10.1177/0269216320920780

M3 - Article

C2 - 32348711

AN - SCOPUS:85083800310

SN - 0269-2163

VL - 34

SP - 889

EP - 895

JO - Palliative medicine

JF - Palliative medicine

IS - 7

ER -