GPs' views of discussions of prognosis in severe COPD

Elkington, Helena; White, Patrick; Higgs, Roger; Pettinari, Catherine Johnson

doi:10.1093/fampra/18.4.440

Cited by 83 publications

(76 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…One reason these patients may receive poor-quality palliative care is that patient-physician communication about end-of-life care is unlikely to occur, or only occurs late in the illness [23][24][25]. The quality of this communication is likely to be poor and current models for training physicians in communication about end-of-life care are inadequate [23,27,80]. Understanding the barriers to this communication may be an important step to improving it [22].…”

Section: Discussionmentioning

confidence: 99%

“…It was found that 84% of physicians waited until dyspnoea was severe and 75% waited until the FEV1 was ,30% pred. A survey of 214 general practitioners in the UK found that, although 82% felt that general practitioners should discuss the prognosis with patients with COPD, only 41% reported ''often'' or ''always'' discussing prognosis with these patients [27]. Furthermore, two thirds of these physicians who reported infrequently discussing end-of-life care reported feeling inadequately prepared to have such discussions.…”

Section: Current State Of Communication About End-of-life Carementioning

confidence: 99%

See 1 more Smart Citation

Palliative and end-of-life care for patients with severe COPD

2007

View full text Add to dashboard Cite

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. For many patients, maximal therapy for COPD produces only modest or incomplete relief of disabling symptoms and these symptoms result in a significantly reduced quality of life.Despite the high morbidity and mortality associated with severe COPD, many patients receive inadequate palliative care. There are several reasons for this. First, patient-physician communication about palliative and end-of-life care is infrequent and often of poor quality. Secondly, the uncertainty in predicting prognosis for patients with COPD makes communication about end-oflife care more difficult. Consequently, patients and their families frequently do not understand that severe COPD is often a progressive and terminal illness.The purpose of the present review is to summarise recent research regarding palliative and end-of-life care for patients with COPD. Recent studies provide insight and guidance into ways to improve communication about end-of-life care and thereby improve the quality of palliative and end-of-life care the patients receive. Two areas that may influence the quality of care are also highlighted: 1) the role of anxiety and depression, common problems for patients with COPD; and 2) the importance of advance care planning.Improving communication represents an important opportunity for the improvement of the quality of palliative and end-of-life care received by these patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Current State Of Communication About End-of-life Carementioning

confidence: 99%

Palliative and end-of-life care for patients with severe COPD

2007

View full text Add to dashboard Cite

show abstract

“…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].…”

Section: Frequency Of Discussionmentioning

confidence: 99%

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

Tavares

Jarrett

Hunt

et al. 2017

Rehabilitation and Chronic Care

View full text Add to dashboard Cite

Chronic obstructive pulmonary disease (COPD) is a chronic life-limiting disorder characterised by persistent airflow obstruction and progressive breathlessness. Discussions/conversations between patients and clinicians ensure palliative care plans are grounded in patients' preferences. This systematic review aimed to explore what is known about palliative care conversations between clinicians and COPD patients.A comprehensive search of all major healthcare-related databases and websites was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were quality assessed, employing widely used quality-assessment tools, with only papers scoring moderate-tohigh quality included. All relevant data were extracted. A narrative synthesis was used to analyse, process and present the final data.The findings indicated that the frequency and quality of palliative care conversations is generally poor. Patients and physicians identified many barriers and important topics were not discussed. Patients and clinicians reported tension between remaining hopeful and the reality of the patients' condition. When discussions did happen, they often occurred at an advanced stage of illness and in respiratory wards and intensive care units.In conclusion, current care practices do not facilitate satisfactory conversations about palliative care between COPD patients and clinicians. This impacts upon the fulfilment of patients' preferences at the end of life. @ERSpublications Conversations about palliative care in COPD http://ow.ly/NlKt307jgRs

show abstract

“…COPD is characterised by airflow limitation that is progressive and not fully reversible [4]. The onset of COPD is generally insidious, with slowly evolving symptoms, and the perception of these symptoms as 'self-inflicted' by patients and physicians may lead to significant delay in medical consultation and initiation of therapy [5,6]. Early diagnosis of this disease is a challenge for the coming years [7].…”

mentioning

confidence: 99%

SELDI-TOF-MS in chronic obstructive pulmonary disease

Xia

Zhang

et al. 2012

Chin. Sci. Bull.

View full text Add to dashboard Cite

Chronic obstructive pulmonary disease (COPD) has a profound impact on daily life, yet remains underdiagnosed and undertreated. This study aims to discover potential protein biomarkers for diagnosis and classification of COPD. Fifty-seven COPD patients and 40 controls were divided into a training set (30 COPD patients, 20 healthy controls) and a test set (27 COPD patients, 20 healthy controls). Serum proteomic profiles were measured using surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF-MS). A classification tree was established using Biomarker Pattern Software (BPS). Next we screened distinct proteins present in patients with acute exacerbations of COPD (AECOPD), stable COPD and healthy controls, in order to establish diagnostic models for classification of COPD. Twenty peaks showed statistically significant differences between COPD patients and healthy controls (P < 0.05). Two proteomic peaks (3167 and 5477 m/z) were chosen by BPS to establish a classification tree in the training set. The sensitivity and specificity of this classification tree were 92.59% and 90.00% respectively in the testing set. Furthermore, differently expressed proteins were detected among the patients with AECOPD, stable COPD, and healthy controls. Two protein profiles (3167 and 4645 m/z) could distinguish between stable COPD patients and healthy controls. Three protein profiles (3167, 2963 and 2973 m/z) could distinguish between AECOPD patients and healthy controls. Three protein profiles (5476, 14039 and 2831 m/z) could distinguish between stable COPD patients and AECOPD patients. SELDI-TOF-MS Proteinchip technology is a quick, easy and practical, high throughput analytic method. It shows the diagnostic models established by distinguished proteomic peaks can discriminate COPD patients from healthy control and can identify different stages of COPD. It will provide a highly accurate approach for diagnosis and clinical staging of COPD. chronic obstructive pulmonary disease, surface-enhanced laser desorption/ionization time-of-flight mass spectrometry, proteomics Citation:Zhang X, Zhang J, Li Q, et al. SELDI-TOF-MS in chronic obstructive pulmonary disease.

show abstract

GPs' views of discussions of prognosis in severe COPD

Cited by 83 publications

References 6 publications

Palliative and end-of-life care for patients with severe COPD

Palliative and end-of-life care for patients with severe COPD

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

SELDI-TOF-MS in chronic obstructive pulmonary disease

Contact Info

Product

Resources

About