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Palliative care and management of troublesome symptoms for people with chronic obstructive pulmonary disease.

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Title: Palliative care and management of troublesome symptoms for people with chronic obstructive pulmonary disease.
Authors: Maddocks, M
Lovell, N
Booth, S
Man, WD-C
Higginson, IJ
Item Type: Journal Article
Abstract: People with advanced chronic obstructive pulmonary disease (COPD) have distressing physical and psychological symptoms, often have limited understanding of their disease, and infrequently discuss end-of-life issues in routine clinical care. These are strong indicators for expert multidisciplinary palliative care, which incorporates assessment and management of symptoms and concerns, patient and caregiver education, and sensitive communication to elicit preferences for care towards the end of life. The unpredictable course of COPD and the difficulty of predicting survival are barriers to timely referral and receipt of palliative care. Early integration of palliative care with respiratory, primary care, and rehabilitation services, with referral on the basis of the complexity of symptoms and concerns, rather than prognosis, can improve patient and caregiver outcomes. Models of integrated working in COPD could include: services triggered by troublesome symptoms such as refractory breathlessness; short-term palliative care; and, in settings with limited access to palliative care, consultation only in specific circumstances or for the most complex patients.
Issue Date: 2-Sep-2017
Date of Acceptance: 7-Jul-2017
URI: http://hdl.handle.net/10044/1/55415
DOI: https://dx.doi.org/10.1016/S0140-6736(17)32127-X
ISSN: 0140-6736
Publisher: Elsevier
Start Page: 988
End Page: 1002
Journal / Book Title: Lancet
Volume: 390
Issue: 10098
Copyright Statement: © 2017, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/
Keywords: 11 Medical And Health Sciences
General & Internal Medicine
Publication Status: Published
Appears in Collections:National Heart and Lung Institute
Airway Disease
Faculty of Medicine



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