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Background: Few studies regarding palliative sedation (PS) have been carried out in-home care (HC) setting. This study aimed to describe the prevalence of PS and its associated factors for end-of-life cancer patients sedated at home in a single institution for 12 months. Patients and methods: A retrospective study was carried out by the Tuscany Tumour Association including adult patients with a diagnosis of onco-haematologic disease, who had undergone palliative sedation at home (HPS) or not (non-HPS), in one year. Sociodemographic variables (sex and age) and clinical variables (primary tumour location, active treatment (AT) or best supportive care at the time of palliative sedation, causes of sedation, duration of sedation) were gathered from the clinical histories of the cohort of patients died at home. Results: From January to December 2018, 591 died at home mean age was 74 years ± 14 years, 311 (52%) patients were males, and 246 (42%) were still on AT. 110 (19%) received HPS. Dyspnoea (52%) and delirium (42%) were the main refractory symptoms leading to HPS. Univariate analysis showed a significant difference between HPS and non-HPS patients according to age and gender with younger (χ² = 2.8, p = 0.0043) male (χ² = 5.5, p = 0.019) patients more likely to undergo PS. Furthermore, adjusted odds ratios for each tumour showed that the risk of sedation was lower among patients with gastrointestinal cancer (OR adj = 0.59; 95% CI: 0.37--0.94), and higher for patients with melanoma (OR adj = 5.36; 95% CI: 1.35--21.24). Conclusions: This study confirms the feasibility and the important role as a therapeutic tool played by HPS in advanced cancer patients. It underlines the importance to pay particular attention to those patients more likely to undergo HPS (i.e. younger, males and/or melanoma patients), limiting useless or detrimental end-of-life antineoplastic treatments. [ABSTRACT FROM AUTHOR]

Background: In Italy medical cannabis is a prescription drug since 1998. Even though it could not be considered a therapy as such, it is indicated as a symptomatic treatment also in cancer patients, to cure iatrogenic nausea/vomiting and chronic pain. Patients and methods: We conducted a knowledge survey about medical cannabis among cancer patients referred to two outpatient cancer care centers and a home care service. Results: From February to April 2018, 232 patient were enrolled; 210 patients were on active disease-oriented treatment (90.5%), while 22 (9.5%) not. Eighty-one percent of the patients have heard about medical cannabis, but only 2% from healthcare professionals. Thirty-four percent of responders thought about using cannabis to treat one or more of their own health problems, especially pain (55%). Despite that, 18% of the participants believe that medical cannabis could have negative effects on their own symptoms. Patients with high educational level better knew cannabis (odds ratio = 3.52; 95% confidence interval: 1.07–11.53), and medical cannabis (odds ratio = 3.21; 95% confidence interval: 1.48–6.98), when compared to patient with low educational level. Patients who were on active disease-oriented treatment better knew medical cannabis (odds ratio = 3.91; 95% confidence interval: 1.26–12.11) compared to "out of treatment" patients. Metastatic patients were less informed about medical cannabis compared to patients on adjuvant treatment. Conclusions: Our survey shows that most of Italian cancer patients know medical cannabis and a third of them have considered using cannabis to treat one (or more) of their own health problems. In the same time, they are poorly informed and do not tend to ask for information about medical cannabis to healthcare professionals. [ABSTRACT FROM AUTHOR]