Palliative care in thoracic oncology

Schönfeld, Nicolas; Blum, Torsten

doi:10.1183/20734735.018111

Cited by 3 publications

(5 citation statements)

References 27 publications

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“…The use of palliative care in advanced respiratory diseases such as lung cancer, COPD, CF and pulmonary hypertension is complex and has been offered in multiple ways including palliative care consultations, direct palliative care team management and specialised centres for palliative care [ 52 ]. The desired outcomes of palliative interventions are to enable early detection of disease exacerbations, provide timely intervention for early symptom management, decrease patient and family/caregiver anxiety, reduce unscheduled visits to the emergency room, prevent hospitalisations, and support advanced care planning to avoid suffering, especially at the end of life.…”

Section: Palliative Care Symptom Management For Patients With Respiramentioning

confidence: 99%

The potential of palliative care for patients with respiratory diseases

Narsavage¹,

Chen²,

Korn³

et al. 2017

Breathe

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Based on the demonstrated effectiveness of palliative care in the alleviation of symptoms and enhancement of life quality, it is important to incorporate palliative care early in the respiratory disease trajectory. Quality palliative care addresses eight domains that are all patient and family centred. Palliative care interventions in respiratory conditions include management of symptoms such as dyspnoea, cough, haemoptysis, sputum production, fatigue and respiratory secretion management, especially as the end-of-life nears. A practical checklist of activities based on the domains of palliative care can assist clinicians to integrate palliative care into their practice. Clinical management of patients receiving palliative care requires consideration of human factors and related organisational characteristics that involve cultural, educational and motivational aspects of the patient/family and clinicians.Educational aimsTo explain the basic domains of palliative care applicable to chronic respiratory diseases.To review palliative care interventions for patients with chronic respiratory diseases.To outline a checklist for clinicians to use in practice, based on the domains of palliative care.To propose recommendations for clinical management of patients receiving palliative care for chronic respiratory diseases.

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Section: Palliative Care Symptom Management For Patients With Respiramentioning

confidence: 99%

The potential of palliative care for patients with respiratory diseases

Narsavage¹,

Chen²,

Korn³

et al. 2017

Breathe

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“…MDM discussion may be beneficial for patients who have already been referred to palliative care to enable delivery of multidisciplinary interventions for symptom relief. It is believed that palliative care is better provided by a multidisciplinary team, and benefits of palliative interventions for symptom control, including medical, surgical and radiation therapy, when used appropriately are well established 22,23 . MDM discussion increases access to treatments including radiotherapy and surgical intervention, 13–16 and Vinod et al .…”

Section: Discussionmentioning

confidence: 99%

“…found discussion at an Australian lung MDM increased recommendation of palliative therapies, including palliative radiotherapy 24 . Decision‐making around these interventions is complex and involves many considerations including prognosis, performance status and patient preference 22,23 . As such, discussion in a multidisciplinary setting is vital to bring together differing expertise, offer consideration of all options including valuable palliative interventions and limit futile care.…”

Section: Discussionmentioning

confidence: 99%

“…It is believed that palliative care is better provided by a multidisciplinary team, and benefits of palliative interventions for symptom control, including medical, surgical and radiation therapy, when used appropriately are well established. 22,23 MDM discussion increases access to treatments including radiotherapy and surgical intervention, [13][14][15][16] and Vinod et al found discussion at an Australian lung MDM increased recommendation of palliative therapies, including palliative radiotherapy. 24 Decision-making around these interventions is complex and involves many considerations including prognosis, performance status and patient preference.…”

Section: Discussionmentioning

confidence: 99%

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Impacts of multidisciplinary meeting case discussion on palliative care referral and end‐of‐life care in lung cancer: a retrospective observational study

Sridharan

Paul

Stirling

et al. 2021

Internal Medicine Journal

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Background Multidisciplinary meeting (MDM) discussion and early palliative care are recommended in lung cancer management. The literature is unclear whether MDM discussion leads to early palliative care and improved end‐of‐life care. Aims To evaluate impacts of discussion at an Australian lung MDM on palliative care referral, and MDM and early palliative care on aggressive end‐of‐life care. Methods A retrospective, cross‐sectional study was conducted of 352 patients diagnosed with primary lung cancer from 2017 to 2019 at the Alfred Hospital, Melbourne. The primary question was whether MDM discussion influenced palliative care referrals. Secondary questions were whether MDM discussion and early palliative care reduced aggressive treatment (chemotherapy, hospitalisation, emergency department visits, intensive care admission and in‐hospital death) during the last 30 days of life. Multivariable logistic regression was used to determine independent association between MDM discussion and palliative care referral. Results MDM discussion did not independently impact palliative care referral. There was reduced likelihood of MDM presentation in patients with metastatic disease (P < 0.0001) and poorer performance status (P = 0.025), and higher likelihood of palliative care referral in these patients (both P < 0.001). MDM discussion reduced end‐of‐life intensive care unit (ICU) admission in patients with metastatic disease (P = 0.04). A palliative care referral‐to‐death interval of ≥30 days was associated with reduced hospitalisation at the end of life (P < 0.0001) and hospital deaths (P = 0.001). Conclusion Discussion at lung MDM did not increase palliative care referral, but did reduce ICU admission among metastatic patients at the end of life. Longer palliative care referral‐to‐death interval was associated with reduced aggressive end‐of‐life care. Further research is needed in these areas.

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“…The current authors previously briefly addressed this question of the integration of pneumological competence and the requirements of an evidence-based, complex concept of care for lung cancer patients, in another European Respiratory Society (ERS) publication [2]. The main focus of the present article is to deepen and stimulate this development in a more scientific manner.…”

Section: Introductionmentioning

confidence: 99%

The lung cancer patient, the pneumologist and palliative care: a developing alliance

Blum

Schönfeld

2014

Eur Respir J

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Considerable evidence is now available on the value of palliative care for lung cancer patients in all stages and at all times during the course of the disease. However, pneumologists and their institutions seem to be widely in arrears with the implementation of palliative care concepts and the development of integrated structures.This review focuses on the available evidence and experience of various frequently unmet needs of lung cancer patients, especially psychological, social, spiritual and cultural ones. A PubMed search for evidence on these aspects of palliative care as well as on barriers to the implementation, on outcome parameters and effectiveness, and on structure and process quality was performed with a special focus on lung cancer patients.As a consequence, this review particularly draws pneumologists' attention to improving their skills in communication with the patients, their relatives and among themselves, and to establish team structures with more far-reaching competences and continuity than existing multilateral cooperations and conferences can provide. Ideally, any process of structural and procedural improvement should be accompanied by scientific evaluation and measures for quality optimisation. @ERSpublications Pneumologists should get more widely involved in palliative care for lung cancer patients

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Palliative care in thoracic oncology

Cited by 3 publications

References 27 publications

The potential of palliative care for patients with respiratory diseases

The potential of palliative care for patients with respiratory diseases

Impacts of multidisciplinary meeting case discussion on palliative care referral and end‐of‐life care in lung cancer: a retrospective observational study

The lung cancer patient, the pneumologist and palliative care: a developing alliance

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