COPD research published in The Lancet
19th September 2017
Researchers based at the Cicely Saunders Institute urge healthcare professionals and policymakers to pay particular attention to improving access to palliative care for patients with chronic obstructive pulmonary disease (COPD) and their families. Research published this month in The Lancet, demonstrates how palliative care improves outcomes for patients with COPD. Owing to the unpredictable nature of the condition, palliative care should be integrated early into respiratory, primary care and rehabilitation services.
People with advanced COPD have distressing physical and psychological symptoms, including breathlessness, pain, cough, fatigue, depression and social and spiritual concerns. They may have limited understanding of their disease and do not discuss end of life care issues in routine clinical care. COPD is a multisystem disease, with effects not limited to the lung. Many people with COPD also have multiple other disorders. COPD is unpredictable and prognosis is uncertain.
But early integration of palliative care improves outcomes for patients. Expert palliative care incorporates rigorous assessment and management of symptoms and concerns, and enhanced communication skills, to find out patients’ preferences for care towards the end of life.
Both non-pharmacological and pharmacological interventions are helpful for patients in alleviating breathlessness. For the management of fatigue, palliative care offers individualised exercise and rehabilitation plans to improve physical activity and independence in daily activities. Self- management with support improves psychological resilience and relieves depression. Other physical symptoms such as cough also benefit from a palliative care approach.
Researchers suggest that healthcare professionals and policy makers pay particular attention to improving access to palliative care for patients with COPD and their families. This includes training and support for clinicians, to enable early detection and management of symptoms, and enhanced communication skills.
This research is part of the Breathlessness Programme at the Cicely Saunders Institute, funded by Cicely Saunders International.
Maddocks M, Lovell N, Booth S, D-C Mann W, Higginson IJ. Palliative care and management of troublesome symptoms for people with chronic obstructive pulmonary disease. The Lancet Vol 390. 988-1002 September 2, 2017.