Simultaneous care clinic: A mono-institutional experience at an ESMO designated center for palliative care.

254 Background: Early palliative care has been shown to improve patient (pts) and caregiver satisfaction, symptom control, quality of end-of-life care, cost and in some cases survival in pts with advanced cancer. In accordance with ASCO, ESMO and AIOM guidelines a Simultaneous Care Clinic (SCC) was set up at Veneto Institute of Oncology (IOV) since 2014. In the Castelfranco Branch of the IOV, SCC started in January 2022. Methods: Data from all consecutive outpatient patients seen in SCC were retrieved from a prospectively maintained database.Data collected included cancer type, status of disease, performance status (PS), ongoing oncological treatment, nutritional evaluation, social evaluation, psychological evaluation, activation of home territorial and/or palliative care services,use of other health services after a first visit and place of death. At the first visit pts were evaluated with validated tools for symptom identification, Edmonton Symptom Assessment (ESAS), distress thermometer, Malnutrition Universal Screening Toll (MUST). Results: From January to December 2022seventy-four pts were evaluated by a multidisciplinary team and re-evaluated 2 months later in terms of improvement or stabilization of symptoms, appropriateness of intervention and outcome. All patients had a metastatic disease and were in active oncological treatment. The median age was 73 y and the most prevalent disease type was gastrointestinal cancers (48%). The median time from first SCC visit to death was 3.8 months; 32 pts are still alive. At the first visit symptom management measures were adopted. The median score for the distress thermometer was 5 with higher prevalence of physical problem. A higher prevalence on 7-10 ESAS score (26% of the pts) was found for pain, fatigue and lack of appetite. At the second visit, an improvement was observed: the median score for the distress thermometer was 4 and ESAS score was 7-10 in 18% of the pts. At first SCC visit, patients deemed in need of home care services were 17 (23%) and for these a formal request for Home Care services activation was sent to the Local Health Territorial Unit (Distretto ULSS). Conclusions: The SCC multidisciplinary assessment represents an organizational model effective in granting a global management of needs with the aim of improving the therapeutic path for patients and their caregivers.