TY - JOUR T1 - Outcomes from an integrated respiratory and palliative care service at an Australian teaching hospital JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2016.PA733 VL - 48 IS - suppl 60 SP - PA733 AU - Natasha Smallwood AU - Michelle Thompson AU - Kim Yeoh AU - Louis Irving AU - Jennifer Philip AU - Brian Le Y1 - 2016/09/01 UR - http://erj.ersjournals.com/content/48/suppl_60/PA733.abstract N2 - The unaddressed palliative care needs of patients with advanced lung disease highlight the urgent requirement for new models of care. The Advanced Lung Disease Service (ALDS) represents such a model, whereby patients with severe, non-malignant respiratory disease receive multidisciplinary specialist clinic review, and telephone and domiciliary nursing support, with management led by the respiratory team.Aims: To examine the activity and care provided by the ALDS.Methods: Demographic and prospective outcome data were collected for 170 consecutive patients (2013-16).Results: 136 patients were included: 75 (55%) male; median age 75 years and primary diagnosis COPD 115 (85%). Median lung function (n=136): FEV1 0.9L (40%), FVC 2.3L (83%) and DLco 7.5 (34%). Median Pa02 on ABG 58.0mmHg, and median MMRC dyspnoea score 4. 94 (69%) patients used home oxygen and 106 (78%) had/undertaking pulmonary rehabilitation.Active dyspnoea management was discussed with all patients. 60 (44%) patients were prescribed opioids for refractory dyspnoea, with median prescribed and consumed daily doses of 12mg and 9mg oral morphine equivalent respectively.91 (67%) patients saw a palliative care doctor in the ALDS clinic and 33 (24%) also received community palliative care. All patients were invited to undertake Advance Care Planning (ACP) and 109 (80%) discussed and/or completed an ACP.40 patients died, 11 (28%) in an acute hospital bed, and the remainder in a palliative care bed, nursing home or at home.Conclusions: The ALDS, an integrated model of respiratory and palliative care, facilitates access to symptom control measures, communication and planning for patients with advanced lung disease. ER -