New models of care for advanced lung disease

Cambridge Breathlessness Intervention Service (CBIS)

“…In addition, support for carers can be helpful in many chronic conditions and may help patients to stay out of hospital longer, and reduce their reliance on clinical services, consistent with the literature from other areas of medicine. There are a number of emerging models of service design to help patients with chronic respiratory disease, 15,16 in which breathlessness is the core symptom when the disease is advanced. New models of care for chronic symptomatic disease is likely to be a growing area of interest and research as the suffering caused by breathlessness grows with the increasing incidence of COPD and lung cancer across the world.…”

A patient-centred model of care incorporating a palliative approach: A framework to meet the needs of people with advanced COPD?

“…(3) Service models to address the needs of this group of patients are increasingly being discussed. (16) A number of barriers contribute to the absence of supportive/palliative care for people with COPD including its unpredictable trajectory and the reluctance of specialist clinicians to discuss end-of-life issues and incorporate a palliative focus of care. (17)(18)(19) There is also a lack of knowledge amongst COPD patients about the likely trajectory of their disease.…”

“…(23) The recognition that active disease management and palliative care are complementary rather than exclusive (3)(4)(5)(6)(7) and the early integration of a palliative approach with active treatment is now being promoted as an appropriate framework for care. (4,16) However, the use of a "patient-centred" or "person-centred" framework for care may provide a more comprehensive, all encompassing strategy. This framework requires an understanding of the multi-dimensional, multi-disciplinary and multi-professional nature of care, as well as recognition that care will be required across several settings during the course of the disease.…”

“…This framework requires an understanding of the multi-dimensional, multi-disciplinary and multi-professional nature of care, as well as recognition that care will be required across several settings during the course of the disease. To date, no chronic disease management models in Australia have delivered this holistic care, although the UK and Canada have begun to develop such models (16) . Placing the patient with advanced COPD at the centre of the model of care, as articulated in a palliative approach, can ensure best practice care is provided and patients' needs are more likely to be met in an appropriate and timely manner.…”

'INSPIRED' Approaches to Better Care for Patients with Advanced COPD

“…Much has been written about the merits of alternative models of care to address the needs of patients and caregivers who are living with advanced COPD [22][23][24][25]. Patients and family caregivers have repeatedly given voice to these concepts [7,9,26].…”