RT Journal Article
SR Electronic
T1 Integrated respiratory and palliative care may improve outcomes in advanced lung disease
JF ERJ Open Research
JO erjor
FD European Respiratory Society
SP 00102-2017
DO 10.1183/23120541.00102-2017
VO 4
IS 1
A1 Natasha Smallwood
A1 Michelle Thompson
A1 Matthew Warrender-Sparkes
A1 Peter Eastman
A1 Brian Le
A1 Louis Irving
A1 Jennifer Philip
YR 2018
UL http://openres.ersjournals.com/content/4/1/00102-2017.abstract
AB The unaddressed palliative care needs of patients with advanced, nonmalignant, lung disease highlight the urgent requirement for new models of care. This study describes a new integrated respiratory and palliative care service and examines outcomes from this service.The Advanced Lung Disease Service (ALDS) is a long-term, multidisciplinary, integrated service. In this single-group cohort study, demographic and prospective outcome data were collected over 4 years, with retrospective evaluation of unscheduled healthcare usage.Of 171 patients included, 97 (56.7%) were male with mean age 75.9 years and 142 (83.0%) had chronic obstructive pulmonary disease. ALDS patients had severely reduced pulmonary function (median (interquartile range (IQR)) forced expiratory volume in 1 s 0.8 (0.6–1.1) L and diffusing capacity of the lung for carbon monoxide 37.5 (29.0–48.0) % pred) and severe breathlessness. All patients received nonpharmacological breathlessness management education and 74 (43.3%) were prescribed morphine for breathlessness (median dose 9 mg·day−1). There was a 52.4% reduction in the mean number of emergency department respiratory presentations in the year after ALDS care commenced (p=0.007). 145 patients (84.8%) discussed and/or completed an advance care plan. 61 patients died, of whom only 15 (24.6%) died in an acute hospital bed.While this was a single-group cohort study, integrated respiratory and palliative care was associated with improved end-of-life care and reduced unscheduled healthcare usage.Integrated respiratory and palliative care is associated with better end-of-life care for patients with advanced lung disease http://ow.ly/mgkn30hlPXV