Identification of Patients With Advanced Chronic Diseases in Need of Palliative Care

Patients with advanced chronic diseases often have complex health needs and may benefit from palliative care. However, many of these patients are not identified early enough to receive appropriate palliative care interventions. This prospective observational study aims to identify hospitalized patients and patients attending a day hospital with advanced chronic conditions who have palliative care needs, using the NECPAL tool. NECPAL is a validated screening instrument designed to identify patients with advanced chronic diseases who may benefit from palliative care, based on clinical indicators, disease progression, functional decline, and health care utilization. Adult patients with advanced oncological and non-oncological chronic diseases will be consecutively evaluated. The NECPAL tool will be applied by trained investigators as part of routine clinical assessment. Patients will be classified as NECPAL positive or NECPAL negative according to predefined criteria. The study will estimate the proportion of patients identified as NECPAL positive, describe their clinical characteristics, and analyze whether they are receiving palliative care. Secondary objectives include comparing clinical variables, comorbidity indices, and mortality between NECPAL-positive and NECPAL-negative patients over follow-up. The results of this study will provide information on the prevalence of palliative care needs among patients with advanced chronic diseases and support early identification strategies in hospital settings.

Sex

All

Minimum age

18 Years

Inclusion Criteria:

* Adults aged 18 years or older.
* Hospitalized patients admitted for an acute medical condition or patients attending a day hospital.
* Presence of at least one advanced chronic oncological or non-oncological disease.
* Ability to provide informed consent or availability of a legally authorized representative to provide consent.

Exclusion Criteria:

* Patients in the last days of life at the time of assessment.
* Patients who die during the acute hospitalization process.
* Patients with end-stage organ failure who are listed for organ transplantation.
* Patients with severe psychiatric disease that interferes with study participation.
* Patients previously included in the study during a prior hospital admission.
* Patients for whom outpatient follow-up cannot be ensured.