Quality Care Archives

New National Patient Registry for Hospital-at-Home Care (NOSPI)

Patient care at home in Greece is becoming more organized and secure with the establishment of the National Registry of Patients Receiving Hospital-at-Home Care (NOSPI), as published in Government Gazette 1995/07.04.2026. The NOSPI program is already in pilot implementation at selected hospitals nationwide, with the goal of full development and operation by the end of 2026, including a digital platform and patient registry.

The new registry aims to systematically record patients receiving NOSPI services, ensuring that care is tailored to individual therapeutic needs. Patient groups eligible for inclusion include, among others, those with tracheostomies, on non-invasive mechanical ventilation, receiving long-term oxygen therapy, on parenteral or gastrostomy feeding, as well as those requiring intensive physiotherapy or mobility rehabilitation. Currently, enrollment primarily focuses on children with severe health conditions and chronically ill patients needing pulmonary care, in collaboration with pilot Reference Centers.

While the NOSPI program is already operating in a pilot phase, universal access for all patients in the country has not yet been achieved. Its development is gradual, with full operation—including digital infrastructure and registry-based documentation—planned by the end of 2026. Strengthening Hospital-at-Home care enables better monitoring and improvement of home care services for patients with long-term needs.

Through the registry, authorities can collect accurate and essential health data, enhancing the quality of services and supporting the design of targeted health policies. Implementation respects personal data protection in line with the General Data Protection Regulation (GDPR), ensuring transparency and public trust.

For families and caregivers, patient enrollment in the NOSPI National Registry means access to more coordinated care, with support delivered directly to their homes. Furthermore, documentation helps evaluate and improve home nursing services, enhancing patient safety and quality of life.

This initiative, combined with the development of the digital platform and registry, aims not only to upgrade home care services but also to reduce hospital congestion and ensure high-quality services for all patients in the future.

Sources (text in Greek) : Government Gazette NOSPI, ODIPY

Text/adaptation: Ifiyenia Anastasiou for Kapa3

Depression and Cancer Mortality: A Critical Link Across Major Cancer Types

Depression is a common but often underrecognized condition among cancer patients, affecting up to 20–30% of individuals diagnosed with the disease. Beyond its impact on quality of life, mounting evidence suggests that depression can significantly influence cancer outcomes, including survival. A recent meta-analysis of 65 cohort studies spanning colorectal, breast, lung, prostate, and mixed cancers provides compelling evidence that depression diagnosed after a cancer diagnosis is associated with a substantially increased risk of mortality.

The analysis revealed that patients with depression faced an 83% higher risk of dying from colorectal cancer, a 59% higher risk in lung cancer, a 74% higher risk in prostate cancer, and a 23% higher risk in breast cancer compared to non-depressed patients. Across mixed cancer types, depression increased the risk of cancer mortality by 38%. These findings underscore that the psychological burden of cancer is not merely an emotional challenge but a critical factor affecting survival outcomes.

Mechanisms Linking Depression and Cancer Outcomes

Depression may influence cancer progression through multiple biological and behavioral pathways. Biologically, depression is associated with chronic systemic inflammation, dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, immune suppression, autonomic dysfunction, oxidative stress, and impaired DNA repair. Elevated pro-inflammatory cytokines, including interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), can contribute to tumor growth and metastasis. In older patients, depression may exacerbate age-related immune dysfunction, creating an environment more permissive to cancer progression.

Behaviorally, depression affects health-related actions and treatment adherence. Depressed patients are more likely to delay seeking medical care, adhere poorly to chemotherapy, radiotherapy, and hormonal therapies, and engage in unhealthy habits such as smoking, poor nutrition, and physical inactivity. Social isolation and reduced support systems further increase vulnerability, compounding the negative impact on survival.

Clinical Implications and Interventions

The strong association between depression and cancer mortality highlights the urgent need to integrate mental health care into routine oncology practice. Psychological interventions, such as cognitive-behavioral therapy (CBT), supportive-expressive therapy, and mindfulness-based approaches, have shown promise in reducing distress and improving adherence to cancer treatment. Pharmacological management, including selective serotonin reuptake inhibitors (SSRIs), may also support mental health and potentially influence cancer outcomes, though more research is needed to understand their role fully. Early identification and treatment of depressive symptoms should be considered a priority for oncologists, mental health professionals, and healthcare policymakers alike.

Limitations and Future Directions

While this meta-analysis provides robust evidence, several limitations should be noted. The observational nature of the studies prevents establishing causality, and differences in study design, depression assessment methods, and patient populations contribute to heterogeneity. Future research should explore longitudinal and randomized studies to clarify causal pathways and identify the most effective interventions to reduce depression-related mortality. Investigating the interactions between depression, inflammation, and cancer biology may also reveal targets for novel supportive therapies.

Depression is not just a psychological burden for cancer patients—it is a significant predictor of mortality across multiple cancer types. These findings call for systematic depression screening and tailored interventions as integral components of oncology care.

Organizations like Kapa3 play a vital role in supporting the mental health of cancer patients, offering resources and guidance that can improve both quality of life and treatment outcomes. Integrating psychological support into cancer care ensures that mental well-being is recognized as an essential part of the healing process.
In line with this mission, Kapa3 participates in MELODIC, a new European initiative dedicated to supporting the mental health of young adults (18–30 years old) living with or beyond cancer.

Read the original article here

KAPA3 at the ESMO Congress: Inspiration and Confirmation That We Are Moving Towards the Future

From October 17 to 20, we attended the ESMO World Congress in Berlin. The event stood out for the active participation of the Greek medical community, which led presentations on clinical data, Real-World Evidence, and up-to-date education in collaboration with the global oncology community. At the same time, Greek teams received awards in various areas (medical, nursing, institutional), inspiring us all with hope for the ongoing developments in oncology care.

Our main goal as KAPA3 was to focus on research addressing the real needs of the population within the framework of the global community. Collaborating with healthcare professionals from around the world allowed us to gather valuable knowledge and experiences. The intensive sessions and discussions broadened our understanding and prompted reflection on the next steps.

Key challenges identified for the patient advocacy community were:

Mandatory multidisciplinary assessment before starting treatment
No patient should begin treatment without undergoing a multidisciplinary assessment, including an oncology nurse, social scientist, and psychologist. This should be considered the minimum standard for all cancer patients.
Certification and quality of multidisciplinary teams
It is our duty to ensure that these teams meet quality standards. Their certification is undoubtedly complex. However, for us at KAPA3, multidisciplinary care is a fundamental criterion for service provision and must be certified. Quality care can significantly improve patient outcomes, as shown by clinical studies and research presented at this year’s congress, with potential improvements in overall survival of up to 10% (Sweden).

We are deeply proud that our work is guided by these standards precisely. In an era of remarkable progress in medicine and new therapies, we continue to strengthen the institution of research and multidisciplinary care, ensuring accessibility and patient-centered approaches aimed at quality of life.

This is the third time we have presented our efforts at an ESMO congress, in collaboration with the International University and the Nursing Department, highlighting our presence at every level. Meanwhile, trainings for other healthcare professionals take place annually within our organization in collaboration with Greek universities.

For Greek patients and their environment, we have not yet reached a point where the quality of care is considered a key objective for the entire oncology community. Our aim is to align with efforts across Europe so that, in the future, multidisciplinary assessments from the first day of diagnosis become standard practice within therapeutic protocols.

At KAPA3, we understand that quality care, inherently multidisciplinary, requires collective effort and collaboration between organizations and professionals to determine the best possible standards.