Letter to the Editor
End-of-life palliative care in times of pandemic: The PADES-COVID experience
Cuidados paliativos al final de la vida en tiempos de pandemia: la experiencia del PADES-COVID
a Adjuntía Dirección Programa de Atención Domiciliaria-Equipos de Soporte y Equipos de Atención Residencial (PADES-EAR), Grup Mutuam, Barcelona, Spain
b Grupo de Investigación en Cronicidad de la Cataluña Central (C3RG), Vic, Barcelona, Spain
c Dirección Programa de Atención Domiciliaria-Equipos de Soporte (PADES), Grup Mutuam, Barcelona, Spain
d Unidad de Valoración Geriátrica Integral (UVGI), Grup Mutuam, Barcelona, Spain
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"titulo" => "End-of-life palliative care in times of pandemic: The PADES-COVID experience" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "239" "paginaFinal" => "240" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Ingrid Bullich-Marín, Emma Costas-Muñoz, Nuria López-Matons" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Ingrid" "apellidos" => "Bullich-Marín" "email" => array:1 [ 0 => "ingridbullich@gmail.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Emma" "apellidos" => "Costas-Muñoz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 2 => array:3 [ "nombre" => "Nuria" "apellidos" => "López-Matons" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Adjuntía Dirección Programa de Atención Domiciliaria-Equipos de Soporte y Equipos de Atención Residencial (PADES-EAR), Grup Mutuam, Barcelona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Grupo de Investigación en Cronicidad de la Cataluña Central (C3RG), Vic, Barcelona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Dirección Programa de Atención Domiciliaria-Equipos de Soporte (PADES), Grup Mutuam, Barcelona, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Unidad de Valoración Geriátrica Integral (UVGI), Grup Mutuam, Barcelona, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Cuidados paliativos al final de la vida en tiempos de pandemia: la experiencia del PADES-COVID" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The recent article by Julià-Torras et al. on pressing reflections from palliative care in the face of the next epidemic of COVID-19<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> mentions the great difficulties encountered in the home and nursing home settings at the beginning of the first wave of the pandemic in Spain.</p><p id="par0010" class="elsevierStylePara elsevierViewall">In the city of Barcelona, 5418 people died between the start of the pandemic and 30 December 2020.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> During the weeks between 28/03 and 12/04 an average of 130–140 patients died in the city of Barcelona per day, with around a third of them dying at home or in a nursing home.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Aware of the difficulty of accessibility to hospitals for palliative patients and the need for people at home to have access to specific palliative care, a specific home palliative care support team (PADES-COVID) was set up in the city of Barcelona on 1 April 2020. In line with the proposals for adapting palliative care services to the pandemic,<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> this action is seen as an example of flexibility and transformation from a conventional PADES service.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The purpose of this letter to the editor is to describe the experience, operation and main results of the PADES-COVID activity during the first wave of the pandemic.</p><p id="par0020" class="elsevierStylePara elsevierViewall">PADES-COVID is a rapid response resource for the care of COVID+ patients or patients with compatible symptoms from any health service of the Catalan Public Health System (SISCAT). It provides care from Monday to Sunday (from 8 am to 8 pm) for patients with palliative needs resulting from SARS-COV-2 infection who were not previously cared for by a PADES. These patients are cared for by professionals in medicine, nursing, social work and psychology, with advanced skills in palliative care. The visits are joint, which allows multidimensional care to be planned and organised on the basis of an assessment of the physical, psychosocial and spiritual needs of the person and their families, incorporating bioethical aspects in decision-making.</p><p id="par0025" class="elsevierStylePara elsevierViewall">During the first two months of PADES-COVID, 180 patients (55.6% women) were treated, with a mean age of 78.8 years. 41.6% were complex chronic patients (CCP) or advanced chronic disease patients (ACDP). Each patient received a mean of 3 (SD 2.65) interventions. 17% of the patients died at the time of the first visit, during the team’s intervention. The follow-up of 76.7% of the patients was carried out by the reference PADES team.</p><p id="par0030" class="elsevierStylePara elsevierViewall">In the first wave of the pandemic, PADES-COVID provided care to a small number of people with palliative needs at home and in nursing homes, compared to those initially planned and to all those who died in the city of Barcelona. Even so, the rating of the resource by the rest of the SISCAT services in the territory was very satisfactory, as well as for the patients and their families and the professionals on the team.</p><p id="par0035" class="elsevierStylePara elsevierViewall">The PADES-COVID, based on the care model and work methodology carried out by the PADES teams over 30 years of experience,<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> has proved to be a good proposal for responding to the emerging palliative needs of COVID-19. It is considered a realistic and feasible proposal and corresponds to the specific proposals for new COVID-19 outbreaks put forward by Julià-Torras et al.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> which include: teams with specific competencies in palliative care; symptom control; psycho-emotional support; support in rapid decision making; and hospital-to-home transfer of patients, among others. For this reason, the need to reactivate it in the face of a possible third wave of the pandemic was considered.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Bullich-Marín I, Costas-Muñoz E, López-Matons N. Cuidados paliativos al final de la vida en tiempos de pandemia: la experiencia del PADES-COVID. Med Clin (Barc). 2022;158:239–240.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "COVID-19: reflexiones de urgencia desde los cuidados paliativos ante la próxima epidemia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J. Julià-Torras" 1 => "N. de Iriarte Gay de Montellà" 2 => "J. Porta-Sales" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.medcli.2020.07.042" "Revista" => array:2 [ "tituloSerie" => "Med Clin (Barc)" "fecha" => "2020" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Generalitat de Catalunya. S/Coronavirus SARS-CoV-2. Situació Actual Catalunya. 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Gálvez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Med Paliat" "fecha" => "2020" "volumen" => "27" "paginaInicial" => "242" "paginaFinal" => "254" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Equipos de soporte domiciliario de cuidados paliativos en España" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Espinosa" 1 => "X. Gomez-Batiste" 2 => "J.M. Picaza" 3 => "E. Limón" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Med Clin (Barc)" "fecha" => "2010" "volumen" => "135" "paginaInicial" => "470" "paginaFinal" => "475" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000015800000005/v1_202203050916/S2387020621005131/v1_202203050916/en/main.assets" "Apartado" => array:4 [ "identificador" => "43309" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000015800000005/v1_202203050916/S2387020621005131/v1_202203050916/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020621005131?idApp=UINPBA00004N" ]
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