DP039 | END OF LIFE APPROACH AND PALLIATIVE CARE FOR PATIENTS WITH LYMPHOMA: A REAL-WORLD PRACTICE SURVEY AMONG FONDAZIONE ITALIANA LINFOMI CENTERS.

Patients with lymphoma experience high-intensity medical care near the end of life (EOL), have low rates of hospice and palliative care (PC), and are more likely to die in a hospital. We developed a survey to investigate this phenomenon, with the intention of analysing the EOL approach and PC perceptions among health professionals who treat lymphoma patients. This was a multicentre exploratory descriptive web-based survey. A questionnaire was administered to 75 Italian haematological units belonging to Federazione Italiana Linfomi (FIL). A total of 41/75 healthcare professionals completed the survey, achieving a 55% response rate with centres representing the whole of Italy (53.6% north, 24.4% centre and 22% south). A PC service is available in 34 (82.9%) of the centres and most of the respondents supported the integration of haematology and PC, despite this, only 9 (22%) centres have a haematologist trained in PC. Within the 34 centres where a PC network is available, in 31 (91.1%) there is a hospice, in 31 (91.1%) a home care PC system and in 27 (87.1%) a PC hospital consultant. Lymphoma patients in the EOL phase are mostly assisted by PC in 30 (73.2%) centers, by the general practitioner in 9 (22%) and by the haematologistalone in 2 (4.8%). This reported rate of recourse to PC is significantly higher than that found in the literature for haematological and even oncological patients. With regard to the timing of PC activation, in 10 (24.4%) centers PC is activated mostly too late when the patient is considered off therapy; in 18 (43.9%) when the patient is still on treatment but with very low chances of cure; finally, in 13 (31.7%) cases PC is activated early in the case of complex symptoms (simultaneous PC). In most responders (23, 67.6%), PC is triggered by the hospital haematologist, and in the remaining 11 (32.4%) cases by the general practitioner. The high rate of PC activation means that only a minority (12, 29.3%) of centres responded that patients mostly die in hospital, while most patients die in more appropriate places such as home (19, 46.3%) and hospice (10, 24.4%). Finally, very interesting is how 15 (36.6%) respondents reported that they propose an “advance care planning” to patients with advanced lymphoma. The results showed that healthcare professionals caring for lymphoma patients generally have a favourable attitude and high interest in integrating palliative care into their patients' care.