Home infusion: Italy’s H-VAS programme supports PICC care at home

Italy has one of the highest percentages of older adults in the European Union,¹ with approximately 24% of the current population over the age of 65.²  At the same time, cancer incidence is increasing in the elderly population more than in the young population.³

In Italy, several government initiatives focus on improving support for family caregivers and personal helpers who provide care in the home setting, as well as programmes aimed at providing greater support to elderly and dependent persons being cared for at home.⁴

Strengthening home care is one of the goals of the care model outlined in Italy’s National Plan for Recovery and Resilience,⁵ which sets out a plan to increase the volume of services rendered in home care, targeted to patients over the age of 65 with one or more chronic and/or dependent conditions.⁵ One of the goals is to maximise the benefits of technologies including telemedicine, home automation and digitisation.⁵

This is echoed in the Europe’s Beating Cancer Plan,⁶ which highlights the important role of family and informal carers, and the toll taken on them in terms of the time required for care activities, and potential loss of income due to reduced work availability.⁶

Study shows no significant difference in PICC complications for inpatients vs. home infusion patients

Dr Pinto shared the results of a study by Mielke et al who retrospectively analysed 522 PICC placements in 484 radiation oncology patients for complications and treatment- and patient-related factors during ambulatory and hospital inpatient use.⁷ The study showed that complications can occur both in inpatients and outpatients, but no significant difference in the number of complications was detected between the two groups.⁷

Complications were similar between the cohort of outpatients (3.6 per 1000 catheter days) and the cohort of inpatients (4.8 per 1000 catheter days.)⁷ The ambulatory patients received weekly PICC care, while the PICCs of inpatients were checked for complications at every drug delivery.⁷ “In cancer patients, the peripherally inserted central venous catheter is feasible and safe if routine care and management are planned,” said Dr Pinto.

Dr Pinto also shared the results from a qualitative content analysis on the supportive care needs of adults living with a PICC at home.⁸ This study showed that caregivers play an integral role, and that it is vital to include them in clinical education programmes, and support them so they can fulfil this role.⁸

More on this topic: PICC line or port catheter: Which one for cancer patients?

Home infusion programme developed to support cancer patients at home

Dr Monica Pinto, Director, S.C Rehabilitation Medicine, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), National Cancer Institute “G. Pascale” Foundation, Naples, Italy, cited these challenges for care providers as key factors in the development of the Home Vascular Access System (H-VAS) programme, launched in Naples, Italy.

Dr Pinto presented an overview of the H-VAS programme at the 8th World Congress on Vascular Access (WoCoVA), held 17 – 19 April 2024 in Prague, Czech Republic. “Quality of life is the most important measure of outcome in chronic diseases such as cancer,” said Dr Pinto.

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