CO10 | The Volemia Fragile Project: internal and geriatric medicine specialists left the hospital to work in the local community. The experience of the Cure Primarie Unit, Pieve di Soligo District, AULSS 2, Veneto Region

Background: The Cure Primarie (CP) Unit medical team is composed of 3 internists e 2 geriatricians, all of them with long hospital experience. The team delivers home visits and consultations to frail patients with chronic diseases and unstable fluid balance. Patients are referred to the CP by General Practitioners, Acute Internal Medicine and Geriatrics wards, chronic heart failure and liver diseases outpatient clinics and community nurses.Aim of the study: To assess the project feasibility, to define patients disease burden and to prove the decrease of Accident and Emergency (A&E) admissions.Materials and Methods: Between May 2022 and January 2024 188 patients were enrolled, 155 of whom with chronic heart failure and/or chronic kidney disease and/or liver cirrhosis. Interventions are: Planned and urgent medical home visits with point of care ultrasound, blood samples, ECG, iv and sc infusions (solutions, diuretics, antibiotics), oxygen therapy, palliative care including end of life sedation. Doctors are available from 8 am to 5 pm five days/w, whereas nurses are on shift 12 hours a day, 7 days/w. E-mails and phone calls are used for patient-doctor/nurse communications.Results: Patients have a high burden of chronic diseases and drugs: 24% with ≥4 diseases; mean numbers of drugs: 9. A reduction in A&E admissions occurred (p<0.05).Conclusions: Preliminary data suggest that the project is feasible and that specialists and nurses working in the community can reduce A&E admissions of chronic patients with fluid imbalance.