A recent article coming out of the Lancet Clinic discusses the need for early palliative care to be integrated into care for people with People with advanced chronic obstructive pulmonary disease (COPD). The article argues that because these patients have distressing physical and psychological symptoms, often have limited understanding of their disease, and infrequently discuss morbidity issues in routine clinical care, they are suitable candidates for palliative care interventions early.
“These are strong indicators for expert multidisciplinary palliative care, which incorporates assessment and management of symptoms and concerns, patient and caregiver education, and sensitive communication to elicit preferences for care towards the end of life,” says the piece. Then authors say that the unpredictable course of COPD and the difficulty of predicting survival are barriers to timely referral and receipt of palliative care.
“Early integration of palliative care with respiratory, primary care, and rehabilitation services, with referral on the basis of the complexity of symptoms and concerns, rather than prognosis, can improve patient and caregiver outcomes.” The piece points to models of integrated palliative care that focus on treating troublesome symptoms such as refractory breathlessness; implementing short-term palliative care; and, in the efficacy of palliative care in settings with limited access to palliative care, among others.
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