Abstract
Background: Chronic Obstructive Pulmonary Disease (COPD) is a progressive disease that in its advanced stages leads to significant impairments.Previous studies suggest that COPD patients receive little palliative care even in very advanced stages.
Aim: To describe the clinical practice of Spanish Pulmonologists in the care of COPD patients at the end-of-life (EoL).
Materials: An on-line survey was sent to members of the Spanish Pneumology Society (SEPAR) including a)symptom management,b) structure and collaboration in each service, c) specialized medical training in palliative care,d) communication with the patient and family e)barriers to treat these patients.
Results: We obtained 203 answers (13% of all contacted). 41% of participants reported treating dyspnea with opioids, 47% reported treating pain and only 34% stated that they treated anxiety/depression. About half of physicians did not have formal protocols to provide palliative care to patients with COPD. Physicians did not usually initiate discussions about EoL issues with their patients. The main barrier to communication about EoL issues were the lack of training (83%) and the belief that patients would not be certain about the type of care that would be preferred when illness progressed (81%).
Conclusions: Education in palliative care to treat patients with advanced COPD is poor among Spanish Pulmonologists. Limited resources are a significant impediment to effective EoL care. The problems identified in this study could provide new areas for improvement.
- Copyright ©the authors 2016
