End-of-life care in COPD: A survey carried out with Portuguese Pulmonologists

Palliative and end of life care conversations in COPD - a systematic literature review

“…17 out of 37 papers highlighted that a variable percentage of COPD patients had discussed palliative care topics, this ranged from 0% to 56%, [5,19,21,24,25,29,30,[35][36][37][38][39][40][41][42][43][44]. Within this group, the majority (n=9), reported rates of discussion ⩽30% of patients [19,29,30,[35][36][37][38][39]43].…”

“…Several studies reported the most frequent and the least discussed topics during palliative care discussions, these are highlighted in table 3 [3,15,20,21,35,39,41,44,[46][47][48][51][52][53]. Overall, patient education about palliative care was ranked as one of the most important topics by patients with COPD [51].…”

“…Conversations about treatment preferences were reported to occur when the patient's COPD was advanced or when a serious decline was noted [3,25,44,47]. Furthermore, the majority of physicians chose to initiate conversations when the forced expiratory volume in 1 s (FEV1) was <30% [3,47].…”

“…The disease features that most commonly triggered palliative care discussions according with clinicians were: FEV1 <30% of the predicted value; on or prior to an intensive care unit admission; when a sudden event had happened, such as the introduction of long-term oxygen and/or noninvasive ventilation; when maximum therapy was achieved; and when all curative treatments were exhausted [3,25,44,47]. These features were chosen by clinicians because these mark an important point in the deterioration of the overall health status of the patient [3,25,44,47].…”

“…These features were chosen by clinicians because these mark an important point in the deterioration of the overall health status of the patient [3,25,44,47].…”