Inclusion criteria of papers selected for review

Paper languagePapers were included if written in English. The first language of all authors is English, therefore the inclusion of papers written in any other language would pose a barrier to thoroughly analyse the papers.
ParticipantsParticipants included were people with COPD and healthcare professionals aged above 18 years old. COPD diagnosis should be done according with GOLD, in which a spirometry is performed showing a FEV1/FVC lower than 70%.
Papers were included if the sample represented 50% or more of patients with COPD, except if the papers were purposely comparing COPD with other diseases. Papers had to include approximately the same amount of COPD patients and patients with other conditions. A 10% margin was used to include or exclude papers. However, the 10% margin was only applied to the larger categories of patients with other diseases.
Study designAll study designs were included in the review. The main purpose of the review was to identify and analyse all data published regarding this subject. Therefore, all study designs were included.
Study qualityPapers were included if presented high or moderate quality. The inclusion of papers with low quality would contaminate the overall findings and conclusion of the review, leading to inaccurate and unreliable data.
Country restrictionOnly papers from North America, Europe, Australia and New Zealand were included. This is thought relevant as literature from countries with different cultural believes towards health and from countries with small healthcare resources would not provide relevant and usable data for a European and North American society.
Information presented in papersPapers were included if more than 50% of the information included was about palliative care conversations with COPD patients. This was done using word count. The papers excluded using this approach contained 30% or less of relevant information. Furthermore, the information contained in these papers did not present new information about the topic discussed.
InterventionConversations included were conversations about the topic “palliative care” between a person with COPD and a healthcare professional.
Discussion topicsPalliative care discussions addressed at least one of the following topics:
  •  “What are the patient's wishes and preferences for palliative and end of life care?”

  •  “What is the patient's and clinician's understanding of palliative care?”

  •  “What care can be offered to the dying patient?”

  •  “What may the end of life care and/or death look like?”

  •  “What may the future be like?”

  •  “What are the patient's preferences for life-sustaining treatments?”

  •  “How long does the patient have to live?”

  •  “What is the desired place of death?”

  •  “Who would the patient like to be present in the time of death?”

  •  “What are the arrangements for after death?”

COPD: chronic obstructive pulmonary disease; GOLD: Global Initiative for Chronic Obstructive Lung Disease; FEV1: forced expiratory volume in 1 s; FVC: forced vital capacity.