An application is developed to identify early palliative needs and the progress of the condition among people with advanced chronic diseases and conditions

The NECPAL program, which is designed for the early identification of people with advanced chronic diseases and palliative care needs in the health and social services, has just launched the NECPAL 4.0 application. The new version includes tools for assessing the progress of conditions in people with advanced chronic diseases or conditions who have palliative needs, using a procedure that is simple, pragmatic and very reliable. The announcement of the new version comes at the same time as World Palliative Care Day, which this year falls on Saturday 9 October. Estimates suggest that there are more than 130,000 people in Catalonia in need of palliative care due to suffering from advanced chronic diseases and conditions such as fragility, multimorbidity, cancer, dementia and organic insufficiency (respiratory, renal, cardiac and others), which affect 1.5% of the population and account for 75% of mortality.

The NECPAL program (the acronym comes from "necessitats pal·liatives" - palliative needs in Catalan), has been developed by the Chair in Palliative Care at the University of Vic - Central University of Catalonia (UVic-UCC) and the Catalan Oncology Institute (ICO) over more than a decade. The project is led by Xavier Gómez-Batiste, the chair's director, and involves several researchers. It focuses on identifying palliative needs for comprehensive and integrated care for people with advanced chronic conditions based on the creation and application of a tool, NECPAL, and using various resources.

Available in more than ten languages

The improvement of the NECPAL tool has led to the creation of the NECPAL 4.0 app, which is the result of the improvement and implementation of various parameters, and adds dimensions including geriatric syndromes and psychosocial symptoms and aspects, and generates evidence about the needs of the people identified. This instrument, which is available in more than 10 languages, has proven its usefulness both for identification "and in the palliative needs identified" and has also "shown its usefulness in improving the quality of services," says Xavier Gómez-Batiste.

"The app allows users to determine developments in patients based on specific parameters that have to be complemented with a multidimensional assessment, with the gradual introduction of palliative care measures, with a gradual process of advanced and shared planning of decisions, and with planning of integrated care," adds the director of the chair.

The challenge of improving the ability to identify the condition's development

One of the goals of version 4.0 has been to improve the ability to ascertain the extent of the condition's development for each person identified, based on six specific clinical parameters. According to Gómez-Batiste, "we believe that this contribution is very relevant, practical and feasible, and adds value to the original palliative approach, since it enables palliative measures focusing on the improvement of quality of life to be introduced gradually and at an early stage."

The NECPAL 4.0 application is based on evaluation by professionals, and includes evaluations and various parameters that can be easily identified in healthcare practice. This instrument uses a list to identify palliative care needs and is subsequently able to draw up a therapeutic plan. "In order to provide comprehensive care, among other things we need to carry out a multidimensional assessment, assess the state of the disease, its values and preferences, identify and care for the primary caregiver, identify and provide leading professionals, and develop a multidimensional therapeutic plan," says Gómez-Batiste.

A course for the early identification of palliative needs in people with chronic diseases

The Chair in Palliative Care at UVic-UCC has also just made the course "Identification of palliative needs to improve comprehensive and integrated care in people with advanced chronic conditions" available to healthcare and social professionals so that they can study this subject in greater depth. The aim is to be able to provide comprehensive and integrated help for these people in all services. This course, which can be accessed online, provides information on the NECPAL program, which is aimed at people with advanced chronic conditions, especially high levels of frailty, multimorbidity, dementia in old age and all kinds of organ failures.