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Introduction: The palliative approach to non-oncological diseases is a relevant aspect in achieving the quality of life of patients; etiologies such as heart failure (HF) should receive this management even from the moment of diagnosis. The present work aimed to describe the integration of palliative care (PC) in the care of patients with HF in Colombia during the first half of 2022. Methodology: A descriptive cross-sectional quantitative study was designed that consisted of surveying health professionals immersed in the care of patients with HF classified by territorial nodes. The survey was designed based on indicators that evaluated the integration of PC in HF care in the Colombian context, related to the provision and referral of PC, patient empowerment, family approach, home care, multidisciplinarity, knowledge and holistic care. Results and discussion: It was found, according to the reviewed literature, that PC is almost nonexistent in the early stages of HF. The difficulty in accessing health services in some regions of the country, combined with the lack of training for palliative care professionals, are the main findings of the study. Conclusions: A low level of integration of PCs in HF in Colombia was evident, which calls for strengthening research and care work in this regard.

Editorial

Introduction: In recent decades, scientific and technological advances have contributed to a reduction in pediatric mortality, accompanied by an increase in children surviving severe illnesses with complex sequelae. Many of these situations require Pediatric Palliative Care Units to ensure comprehensive and continuous care. In Spain, approximately 2,500 children die each year and up to 25,000 may require specific pediatric palliative care resources.

Material and methods: Epidemiological, observational, and descriptive cohort study comparing healthcare costs before and after implementation of the ADPAP program, initiated on June 1, 2022. The sample included children enrolled in the program who were also followed by the Pediatric Palliative Care Unit of the Complejo Hospitalario Universitario de Canarias, with healthcare expenditure data available for one year before and one year after implementation.

Results: Of the 70 patients included in the program, 17 had comparable data for both periods. The comparison of total mean costs per patient showed a statistically significant reduction after implementation (t = 3.11; p = 0.0067), with an average saving of €9,170.68 per patient. This represents total savings of €155,901.57 in the analyzed cohort.

Conclusion: The implementation of the ADPAP program proved economically efficient, reducing healthcare costs associated with hospital and primary care services. In a hypothetical extrapolation to a cohort of 70 patients with similar characteristics, annual savings could exceed €600,000, although this estimate should be interpreted cautiously. These findings suggest that coordinated pediatric home care from Primary Care may improve healthcare system efficiency and continuity of care for children with complex chronic conditions, reducing avoidable hospitalizations and optimizing the use of hospital resources.

Introduction: Red blood cell and platelet transfusion is a treatment used at the end of life for symptomatic relief. However, its benefits, as well as the survival time after transfusion, are debated. This study aims to determine the prevalence, clinical characteristics, whether or not patients received palliative care, and survival of these patients to guide future studies and facilitate decision-making.
Patients and methods: This was a descriptive, cross-sectional study with retrospective data collection. Sociodemographic, clinical, and diagnostic variables, as well as whether patients received palliative care, treatment, and complications, were included. All adult patients with solid organ cancer who received red blood cell and/or platelet transfusions in the last 6 months of life and were treated at a high-complexity hospital between 2019 and 2022 were included. Data were obtained through review and analysis of medical records after authorization from the institutional ethics committee and entered into the BDClinic platform. Univariate and bivariate analyzes were performed for each variable.

Results: A population of 234 patients who met the selection criteria was analyzed. The median age was 61.8 years, and 60% of the population were women. The most common cancer was gastrointestinal (42.74%). Early palliative care intervention was associated with 31.5% of all transfusions and a median survival of 20 days from the last red blood cell transfusion. Patients receiving palliative care exclusively had a median survival after transfusion of 18 days, the longest compared to the other groups.

Conclusions: The appropriateness of therapeutic measures such as transfusions is plausible with early intervention by palliative care, and this is a bioethical imperative that plays a crucial role to consider in the final phase of life.

Introduction: Palliative care enhance the quality of life for those dealing with a terminal illness. However, many people are unable to access this type of care, especially in Latin American countries. Therefore, the aim of this study is to determine the effect of an educational intervention program on palliative care among medical students.
Material and Method: This quasi-experimental study involved sixth-year students from the Faculty of Human Medicine at the Universidad Científica del Sur of any age and gender who wished to participate in the study. A previously translated and adapted questionnaire for undergraduate students in our country, originally from Japan, was used to measure the level of knowledge about palliative care among healthcare professionals. The sample was described using frequency tables for each variable pre- and post-test. Normality of the scores obtained in each section of questions was determined using the Shapiro-Wilk test, and since normal distribution was not found, these results were compared using the Wilcoxon test. Finally, a "score variation" variable was created to determine the association of gender, age, and learning type with this variation.
Results: A total of 37 students were evaluated in the study. The total post-intervention score improved significantly compared to the initial score. No association was found between the score variation (pre- and post-test) and age, gender, or learning style.
Discussion: The educational intervention demonstrated a favorable impact on the initial results. Compared to other studies, the educational intervention increased the participants' mastery of palliative care in all sections of questions, especially in "Palliative Care Symptomatology" and "Pharmacology." The incorporation of academic programs on palliative care in Peruvian universities is suggested.

Introduction:
Population aging and the increasing burden of chronic diseases have led to a growing demand for comprehensive healthcare. Palliative Care (PC) has become an essential component in relieving physical, emotional, and social suffering in patients with advanced chronic illnesses. This study aimed to evaluate mortality in hospitalized patients with chronic diseases requiring Palliative Care and to analyze factors associated with referral to specialized PC services.
Materials and Methods:
An ambispective cohort study was conducted at the American British Cowdray Medical Center in Mexico City between July 2024 and March 2025. Adult patients hospitalized in the Internal Medicine service with advanced chronic diseases and positive NECPAL criteria were included. The primary outcome was mortality (in-hospital or out-of-hospital). The main exposure variable was referral to the Palliative Care team. Bivariate and multivariate logistic regression analyses were performed to identify factors associated with referral and mortality.
Results:
A total of 65 patients were included; 32 (49.2%) received a Palliative Care consultation. No significant differences were observed in age, sex, comorbidity burden, or NECPAL score between patients with and without referral. Overall mortality was 60%, predominantly in-hospital. Referral to Palliative Care was not independently associated with mortality. Family request for Palliative Care was the only factor significantly associated with referral (OR 9.83; 95% CI 1.13–85.2; p=0.038). Only 11% of patients had an advance directive.
Conclusions:
Despite a high prevalence of palliative care needs among hospitalized patients with advanced chronic diseases, referral to specialized Palliative Care services remains limited and largely driven by family request rather than standardized clinical criteria. These findings highlight the need to strengthen systematic identification strategies and medical education to promote timely integration of Palliative Care.

Objective: This study describes the utilization patterns of subcutaneous drug administration within the clinical research framework of palliative care focusing on patients treated at the University Hospital of Móstoles.
Patients and method: Conducted as a retrospective observational study, this investigation meticulously analyzed patient records in the admission regime between January 2022 and March 2023. Sociodemographic, clinical and data related to the use of the subcutaneous route were recorded. The data were analyzed using SPSS version 30.0. Global descriptive statistics were stratified according to whether the subcutaneous route was used. Data regarding the use of the subcutaneous route were further stratified based on whether patients had cancer.
Results: 297 patients were included. Subcutaneous route was used in 37.04 % of cases. Subcutaneous route use varied depending on the diagnosis, being more prevalent in patients with dementia (65.5 %), and was associated with non-cancer patients. The main reason was symptomatic control (68.2 % of cases), especially in cancer patients (76.6 %). A different profile of symptoms to be controlled was identified between cancer patients (pain, agitation, dyspnea) and non-cancer patients (dyspnea, agitation, secretions), although no significant differences were found either in the drugs used (mainly morphine chloride, butylscopolamine, midazolam and haloperidol) or in the use of the route (greater use of continuous perfusion).
Conclusions: Our results suggest a low use of the subcutaneous route in palliative patients in hospital settings, despite being considered an effective and safe therapeutic alternative for the management of palliative patients. Its predominant use was observed in non-cancer patients and for symptomatic control. Insufficient records of the location catheter placement and complications associated with the use of the route, as well as the retrospective collection of data, were important limitations of the study. This study lays the groundwork for further research in this field.