Palliative and End-of-life Care for Patients with Severe COPD

¹ Professor of Medicine, Division of Pulmonary and Critical Care Medicine, University of Washington, Seattle, WA

^* To whom correspondence should be addressed. E-mail: jrc{at}u.washington.edu.

	Abstract

COPD is a leading cause of morbidity and mortality worldwide. For many patients, maximal therapy for COPD produces only modest or incomplete relief of disabling symptoms and these symptoms result in a significantly reduced quality of life. Despite the high morbidity and mortality associated with severe COPD, many patients receive inadequate palliative care. There are several reasons for this. First, patient-physician communication about palliative and end-of-life care is infrequent and often of poor quality. Second, the uncertainty in predicting prognosis for patients with COPD makes communication about end-of-life care more difficult. Consequently, patients and their families frequently do not understand that severe COPD is often a progressive and terminal illness. The purpose of this review is to summarize recent research regarding palliative and end-of-life care for patients with COPD. Recent studies provide insight and guidance into ways to improve communication about end-of-life care and thereby improve the quality of palliative and end-of-life care the patients receive. Two areas that may influence the quality of care are also highlighted: 1) the role of anxiety and depression, common problems for patients with COPD; and 2) the importance of advance care planning. Improving communication, represents an important opportunity to improve the quality of palliative and end-of-life care received by these patients.

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