RT Journal Article SR Electronic T1 Palliative and end-of-life care conversations in COPD: a systematic literature review JF ERJ Open Research JO erjor FD European Respiratory Society SP 00068-2016 DO 10.1183/23120541.00068-2016 VO 3 IS 2 A1 Nuno Tavares A1 Nikki Jarrett A1 Katherine Hunt A1 Tom Wilkinson YR 2017 UL http://openres.ersjournals.com/content/3/2/00068-2016.abstract AB Chronic obstructive pulmonary disease (COPD) is a chronic life-limiting disorder characterised by persistent airflow obstruction and progressive breathlessness. Discussions/conversations between patients and clinicians ensure palliative care plans are grounded in patients' preferences. This systematic review aimed to explore what is known about palliative care conversations between clinicians and COPD patients.A comprehensive search of all major healthcare-related databases and websites was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were quality assessed, employing widely used quality-assessment tools, with only papers scoring moderate-to-high quality included. All relevant data were extracted. A narrative synthesis was used to analyse, process and present the final data.The findings indicated that the frequency and quality of palliative care conversations is generally poor. Patients and physicians identified many barriers and important topics were not discussed. Patients and clinicians reported tension between remaining hopeful and the reality of the patients' condition. When discussions did happen, they often occurred at an advanced stage of illness and in respiratory wards and intensive care units.In conclusion, current care practices do not facilitate satisfactory conversations about palliative care between COPD patients and clinicians. This impacts upon the fulfilment of patients' preferences at the end of life.Conversations about palliative care in COPD http://ow.ly/NlKt307jgRs