Is hospitalisation for COPD an opportunity for advance care planning? A qualitative study

Seamark, David; Blake, Susan; Seamark, Clare; Hyland, Michael E.; Greaves, Colin; Pinnuck, Margaret; Ward, Darrell N.; Hawkins, Adam; Halpin, David

doi:10.4104/pcrj.2012.00032

Cited by 38 publications

(75 citation statements)

References 27 publications

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“…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]. This information was generated from papers including qualitative and quantitative studies with moderate and high quality, papers which compared COPD patients and patients with other diseases and narrative reviews.…”

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

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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

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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

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show abstract

“…In Canada, the UK, New Zealand and the USA, policy makers are calling for changes in health professional education to improve collaborative practice. 9 Findings from the study by Seamark et al 2 confirm both the need for, and the well-documented difficulty implementing, ACP for patients with COPD. No patients could recall discussion in hospital about issues of resuscitation, the possibility of being ventilated, or planning for future exacerbations.…”

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confidence: 83%

“…The aim of such a service is therefore to deliver better outcomes for people living with COPD and to reduce hospital admissions, emergency department attendance, and urgent general practitioner (GP) visits. Seamark et al 2 address the narrower (often neglected) aspect of ACP, which requires patient understanding about prognosis and options for end-of-life care.…”

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confidence: 99%

“…In the Seamark study, the qualitative approach is used to understand patient views about when and who should introduce the topic of advance care planning, 2 and in the Cleland study it is used to examine the attitudes of a range of stakeholders -patients, carers and healthcare providers currently delivering COPD care -to a potential new service. 1 The results of qualitative research, although limited in generalisability, can be a powerful tool for sensitising policymakers and practitioners to the perceptions of health service users and healthcare professionals.…”

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confidence: 99%

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Anticipating the outcomes and care choices for people living with COPD

Goeman¹,

Walters²,

Ross

2012

Primary Care Respiratory Journal

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“…an acute exacerbation [22]. An important aspect of the ACP is to involve both the formal and informal caregivers [23].…”

Section: Definitionmentioning

confidence: 99%

Danish respiratory society position paper: palliative care in patients with chronic progressive non-malignant lung diseases

Marsaa

Gundestrup

Lange

et al. 2018

European Clinical Respiratory Journal

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Background: Chronic non-malignant lung diseases such as chronic obstructive pulmonary disease (COPD) and interstitial lung diseases (ILD) result in reduced quality of life (QoL), a high symptom burden and reduced survival. Patients with chronic non-malignant lung disease often have limited access to palliative care. The symptom burden and the QoL of these patients resembles patients with cancer and the general palliative approach is similar. However, the disease trajectory is often slow and unpredictable, and the palliative effort must be built on accessibility, continuity and professional competences. The Danish Health Authority as well as the WHO recommends that there is access to palliative care for all patients with life-threatening diseases regardless of diagnosis. In 2011, the Danish Health Authority requested that the national medical societies would to formulate guidelines for palliation. Methods: In 2015, a group of members of the Danish Respiratory Society (DRS) was appointed for this purpose. It was composed of experienced ILD and COPD researchers as well as clinicians from different parts of Denmark. A literature review was made, a draft was prepared, and all recommendations were agreed upon unanimously. Results: The Danish version of the position paper was finally submitted for review and accepted by all members of DRS. Conclusion: In this position paper we provide recommendations on the terminology of chronic and terminal lung failure, rehabilitation and palliative care, advanced care planning, informal caregivers and bereavement, symptom management, the imminently dying patient, and organization of palliative care for patients with chronic non-malignant lung diseases.

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Is hospitalisation for COPD an opportunity for advance care planning? A qualitative study

Abstract: Background: It is recognised that patients with chronic obstructive pulmonary disease (COPD) should have the chance to discuss endof-life care and advance care planning (ACP). Admission to hospital with an exacerbation may be a possible opportunity.

Cited by 38 publications

References 27 publications

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

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

Anticipating the outcomes and care choices for people living with COPD

Danish respiratory society position paper: palliative care in patients with chronic progressive non-malignant lung diseases

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