Palliative care for people with COPD: we need to meet the challenge

Abstract

SummaryThe need to extend the palliative care approach to people dying with a wide range of chronic diseases is increasingly recognised. Whilst of relevance internationally, this topic is particularly timely in the UK as the General Medical Services contract will reward practices that create a register of patients ''in need of palliative/supportive care''. Difficulty predicting prognosis can lead to uncertainty about which patients with COPD to include in a register, potentially reducing the impact of this initiative. In this Discussion paper we highlight this challenge, and offer some practical strategies to help clinicians recognise these patients.

Early identification of palliative care patients in general practice: development of RADboud indicators for PAlliative Care Needs (RADPAC)

“…49 Comparison with existing literature Several lists are available that encourage physicians to identify patients who could benefit from palliative care. 20,[50][51][52] However, this study is the first to present indicators British Journal of General Practice, September 2012 e628…”

Palliative care or end-of-life care in advanced chronic obstructive pulmonary disease A prospective community survey

“…3,[6][7][8][9]37 The experience of palliative care specialists suggests that there are individuals with advanced COPD who have end-of-life care needs that are comparable to the needs of people with advanced cancer. In this study, people with advanced COPD in primary care seldom wished to frame their needs within an 'end-of-life care' context.…”

“…[1][2][3][4][5] They have led to increasing calls for the palliative care of patients with advanced COPD. [6][7][8][9] Despite growing interest, palliative care needs in COPD have not been described, nor has their prevalence been measured prospectively. There is no reliable guidance for generalists or specialists on how COPD sufferers who may have palliative care needs should be identified or how such needs should be discussed.…”

Access to care in advanced COPD: factors that influence contact with general practice services

“…A palliative care approach in advanced chronic obstructive pulmonary disease (COPD) has recently become a recognisable theme within the literature, [1][2][3][4][5][6][7][8][9][10][11][12] with increasing recognition of the need for symptom control. Good access to general practice may enable access to primary palliative care and referral to specialist services, even when prognosis is uncertain.…”