Preventive prescription of medications for the management of potential, catastrophic events in patients with advanced cancer: A Questionnaire Survey among Italian Palliative Care Specialists
Ti chiedo di partecipare al questionario online "Preventive prescription of medications for the management of potential, catastrophic events in patients with advanced cancer: A Questionnaire Survey among Italian Palliative Care Specialists” promosso dall'Unità Operativa di Oncologia Medica dell’Azienda Ospedaliera Sant’Andrea di Roma.
Gli eventi cosiddetti "catastrofici" in oncologia come ad esempio un significativo sanguinamento gastrointestinale o un'emottisi massiva rappresentano una condizione possibile e potenzialmente fatale nei pazienti in fase avanzata di malattia. Vengono pertanto definiti eventi catastrofici o critici. Esistono ad oggi pochissime le evidenze in letteratura in merito alla gestione clinica e alla prevenzione di questi eventi così come linee guida che orientino il clinico nella loro gestione.
Il Nostro obiettivo sarà quello di conoscere e descrivere l'approccio dei medici che lavorano in cure palliative in merito alla prescrizione di farmaci e presidi volti alla prevenzione e alla gestione di questi eventi catastrofici.
L’obiettivo della Nostra Survey sarà valutare tra i medici italiani esperti in cure palliative la reale incidenza di questo fenomeno e tutte le caratteristiche ad essa associate.
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Please indicate your age
Please indicate the Italian region where you work
Friuli Venezia Giulia
Trentino Alto Adige
Please indicate Your Medical Specialization
Do You Have a Palliative Medicine Specialization or a Certification of Palliative Medicine Consultant?
In which settings do you work ?
Palliative Care Unit/Hospice Care
Do you work predominantly in adult or paediatric palliative medicine?
What do you consider to be potential catastrophic event(s) that might prompt a pre-emptive medication order? (check all that apply)
Significant visible bleeding (e.g. haemoptysis, haematemesis)
Severe, acute airway obstruction
What term do you use when pre-emptively prescribing medication for the management of potential catastrophic events?
Have you ever pre-emptively prescribed medication(s) for a potential catastrophic event?
On average, how many times per year do you pre- emptively prescribe medications for potential catastrophic events? (IF YES TO 7)
10 or more
What proportion of the orders you have written have been administered? (IF YES TO 7)
Based on your training, what do you believe to be the role of preventive prescribed medications for potential catastrophic events? (check all that apply)
To reduce patient consciousness
To minimise patient distress
To reduce patient suffering by hastening death
To give nursing staff/carers something to do in
Such a distressing situation
What medication(s) would you pre-emptively prescribe for potential catastrophic events? (check all that apply)
Levomepromazine (or other phenotiazines)
How would you calculate the medication dose?
2–3× the breakthrough dose
4–7× the breakthrough dose
8–10× the breakthrough dose
I have standard doses I use
When pre-emptively prescribing these medications, with what frequency would you write them up?
Stat dose (once only)
5 minutely PRN
10 minutely PRN
15 minutely PRN
When pre-emptively prescribing these medications, what route would you specify in your order? (check all that apply)
When ordering pre-emptive medications for a potential catastrophic event, would you stipulate timing of a medical review?
What would you stipulate about notifying medical staff to review the patient? (IF YES to 13)
Before any pre-emptively prescribed medica- tion is administered
After the first dose(s) of pre-emptively pre- scribed medication is administered
After the second dose(s) of pre-emptively prescribed medication is administered
After the third dose(s) of pre-emptively pre- scribed medication is administered
How did you learn about the pre-emptive prescription of medications for potential catastrophic events? (check all that apply)
Published, peer-reviewed papers
From a senior colleague during my training
How confident do you feel pre-emptively prescribing medications for potential catastrophic events?
Not at all confident
Are you aware of any adverse outcomes for patients, staff or family/caregivers, that have occurred because of the pre-emptive prescription of medications for a potential catastrophic event?
Are you aware of any adverse outcomes for patients, staff or family/caregivers, that have occurred because medications WERE NOT pre-emptively prescribed for a potential catastrophic event?
Would your practice around pre-emptive medication prescription vary depending on location of care, e.g. hospital versus home?
Do you have any ethical or other concerns about this area of practice?
Do you feel that nursing staff receive adequate training around when to administer medications that have been pre-emptively prescribed for apotential catastrophic event?
Does this impact whether you prescribe these medications?
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