Tumori Journal Abstract Book - October 2020 - 207

U - Oncology Nursing
Catalano V.1, Graziano F.1, Baldelli A.M.1, Alessandroni P.1, Sarti D.1,
Rossi D.1, Luzi Fedeli S.1
1

Azienda Ospedaliera Ospedali Riuniti Marche Nord, UO Oncologia, Pesaro

Background: This prospective study monitored the impact
of regular pain assessment by nurses, as concerning pain
management in hospitalized cancer patients. The results of
this study were compared with those obtained in a similar
investigation that was performed ten years ago, to investigate the attitude changes in pain management.
Material and Methods: A monocentric qualitative and quantitative investigation on cancer-related pain was carried out on
patients that were hospitalized in oncology, with pain at admission and hospitalization for at least three days. Pain intensity
was asked twice a day to patients and reported by nurses and
with a NRS scale (no pain=0, mild=1, moderate=2, strong=3).
Pain management evaluation was performed with the Index of
pain-management (IPM). IPM measured the health care provided in response to patient's pain. Such response was considered adequate when there was a congruence between patient's
reported pain intensity and the type of prescribed drug. IPM
was assessed subtracting the pain level from no pain=0 to
severe=3) from the analgesic level (four different scores from
no analgesic=0 to strong opioid=3).
Results: From march to September 2019, 106 hospitalized
patients were enrolled in the study. Their median age was 71
years (34-69), M/F was 65/67 and their median inpatients
recovery was 12 days (3-48). Most frequent tumour sites
were Lung 25%, Colorectal 15%, Gastric 10%. Single/multiple metastases (liver 24%, bone 21%, nodes 15%, peritoneal 13%, brain 12%, lung 6%) were present in 61/71
patients. 33 pts reported mild PPI, 32 pts moderate PPI and
41 pts strong PPI. No analgesic was administered to 9 pts,
Non Opioid drugs were administered to 23 pts, weak opioid
to 13 pts and strong opioid to 61 pts. IPM negative levels
were observed in 24 pts (-2 in 10 pts, -1 in 14 pts), IPM 0
level in 49 pts, IPM positive level in 33 pts (1 in 20 pts, 2 in
13 pts) and IPM from 0 to 2 level in 82 pts (77%). Pain was
reported correctly 99% by nurses and 76% by physicians.
Conclusions: Despite several guidelines there is still a
subset of pts whose comfort and pain control is suboptimal. The regular daily reporting by nurses improves the
correct evaluation of pain intensity and pain aspects as
shown an historical comparison with previously evaluation IPM positive score from 57% to 77%. Adequate training for health care providers in pain management lead to
an improvement in cancer pain management.

U06
Tha Case Manager at the time of
the Covid19
Muroni L.1, Cremona G.1, Di Nunzio C.1, Muroni M.1, Gubbelini M.2,
Cavanna L.1

207
1
Dipartimento Oncoematologico AUSL Piacenza, Piacenza; 2Direzione delle
Professioni Sanitarie AUSL Piacenza, Piacenza

Background: In Piacenza it all started on 21 February
2020.The local hospital that the gravity of the situation
was perceived more clearly, and the actions that were
needed to reorganise happened quickly. Among the various interventions that were rapidly approved, was the creation of a team capable of bringing care home to home.
Case managers work to meet patient needs through assessment, coordination, and planning, and by evaluating the
available. The nursing directors wanted the presence of a
case manager within the team made up of the nursing coordinator and the medical manager.
Materials and methods: The need to give quick answers
to a tragic situation has highlighted how telephone contact
can be used to integrate take-up interventions aimed at preventing hospitalizations and early treatment. The telephone
is an important communication tool and can be used to provide information to the patient, to control it remotely, to prevent it from going to the clinic. In the period between 12
March and 30 April, 240 phone calls were made by the case
manager in patients suffering from symptoms attributable to
the covid who requested, leaving a message to a dedicated
number, a service. Each visit was preceded by a phone call
in which the case manager monitored with the aid of a specially designed card the comorbid symptoms, the presence
of symptoms, the therapy taken. The telephone interview
lasted an average 5 minutes. The completed forms were
evaluated by the team that established the priority of access
to the home based on the data collected. The evaluation was
carried out by the team daily and determined the choice of
patients to visit on the following day Home visits were 220
while 20 patients were managed with only telephone contact. It was 20 people who reported a temperature not
exceeding 37.5 degrees and no other symptoms. These 20
patients were indicated the drug therapy to be taken by the
team's medical contact and given as an indication if there
was a worsening recall. For these 20 patients it was decided
to make a follow-up call after 10 days.
Results: 20 patients followed by telephone, 15 reported an
improvement in symptoms, 5 had the need to be visited.
Everyone reported feeling taken care of and reducing anxiety.
Conclusions: The choice of the presence of the case manager allowed, through the intervention of the phone call, to
reduce access to the emergency room and the visits n
charge. No less important is the reduction of anxiety.

U07
"I already take too many drugs":
a research on the reasons of
non - adherence to painkillers
prescriptions in oncological
patients in active care

Tumori Journal Abstract Book - October 2020

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