Palliative Care Provision for Patients with Advanced Chronic Obstructive Pulmonary Disease: A Systematic Integrative Literature Review

Abstract

Although chronic obstructive pulmonary disease (COPD) is recognized as being a life-limiting condition with palliative care needs, palliative care provision is seldom implemented. The disease unpredictability, the misconceptions about palliative care being only for people with cancer, and only relevant in the last days of life, prevent a timely integrated care plan. This systematic review aimed to explore how palliative care is provided in advanced COPD and to identify elements defining integrated palliative care. Eight databases, including MEDLINE, EMBASE and CINAHL, were searched using a comprehensive search strategy to identify studies on palliative care provision in advanced COPD, published from January 1, 1960 to November 30, 2017. Citation tracking and evaluation of trial registers were also performed. Study quality was assessed with a critical appraisal tool for both qualitative and quantitative data. Of the 458 titles, 24 were eligible for inclusion. Experiences about advanced COPD, palliative care timing, service delivery and palliative care integration emerged as main themes, defining a developing taxonomy for palliative care provision in advanced COPD. This taxonomy involves different levels of care provision and integrated care is the last step of this dynamic process. Furthermore, palliative care involvement, holistic needs' assessment and management and advance care planning have been identified as elements of integrated care. This literature review identified elements that could be used to develop a taxonomy of palliative care delivery in advanced COPD. Further research is needed to improve our understanding on palliative care provision in advanced COPD.

Living with Advanced Chronic Obstructive Pulmonary Disease: A Qualitative Interview Study with Patients and Informal Carers

“…31 Palliative care services are designed to deliver multiprofessional care, while managing multidimensional complexity and they could play a role in the development of a care network for patients with advanced COPD. 32 Awareness about palliative care and its role in care delivery of patients with advanced COPD was lacking. None of the participants reported that healthcare services provided them with information about palliative care, the ones who were informed gathered their knowledge through their social network.…”

Psychosocial Interventions for Patients with Severe COPD—An Up-to-Date Literature Review

“…Recent studies brought a basic taxonomy of palliative care in advanced COPD [27]. Still, some unresolved issues remain and need to be addressed if palliative care is to be standardised and widely recommended [7,15,19].…”

Palliative care integration for patients with advanced chronic obstructive pulmonary disease (COPD): Identifying essential components using participatory action research

“…33 This study was supported by a systematic review of the literature performed prior to the current research. The review identified a taxonomy involving different levels of care provision, where integrated care is the last step of a dynamic process of care delivery 16 . These results helped to raise awareness within the CIG about organisational changes that are necessary to develop integrated care.…”

“…15 A systematic review of the literature on palliative care integration in advanced COPD performed prior to this study, underlined the importance of organisational changes that are necessary to develop integrated care. 16 This helped to focus the research aim on how to identify practices designed to increase palliative care integration for patients with advanced COPD in a respiratory service in Southern Switzerland through a participatory action research approach, supported by a ToC framework.…”