Abstract
Background Identifying a point of transition to palliative care in COPD is problematic. We thus propose linking proactive holistic assessment of supportive care needs with milestones throughout a patient’s journey.
Aim To pilot HELP-COPD: holistic intervention delivered at home after hospital admission with COPD.
Method We recruited 30 inpatients at two NHS Lothian hospitals. After discharge a respiratory nurse assessed social/psychological/spiritual/physical needs, provided advice/information and made further clinical/social care referrals. A summary was given to the patient and their general practitioner. Follow-up included three phone calls over six months. A researcher interviewed participating patients, lay-carers and health professionals to assess feasibility and acceptability.
Results Patients were generally positive about the assessment, openly discussing concerns and coping strategies in all domains and appreciating the opportunity for conversation as opposed to completing forms. Professionals considered that the intervention was feasible but identified fewer unmet needs than expected, and some patients were reluctant to access proffered services/information. Participants highlighted overlap with discharge planning and case management provided by community teams.
Conclusion The HELP COPD holistic assessment was feasible and generally welcomed by patients. Fewer actions were identified than anticipated; perhaps due to a combination of inappropriate timing, reluctance to accept social services, long-term adaptation reducing recognition of need, duplication by existing services.
Funding Dunhill Medical Trust.
- © 2013 ERS