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European Respiratory Society Clinical Practice Guideline: Palliative care for people with chronic obstructive pulmonary disease or interstitial lung disease

Daisy J.A. Janssen, Sabrina Bajwah, Michele Hilton Boon, Courtney Coleman, David C. Currow, Albert Devillers, Chantal Vandendungen, Magnus Ekström, Ron Flewett, Sarah Greenley, Mai-Britt Guldin, Cristina Jácome, Miriam J. Johnson, Geana Paula Kurita, Matthew Maddocks, Alda Marques, Hilary Pinnock, Steffen T. Simon, Thomy Tonia, Kristoffer Marsaa
European Respiratory Journal 2023; DOI: 10.1183/13993003.02014-2022
Daisy J.A. Janssen
1Department of Research & Development, Ciro, Horn, The Netherlands
2Department of Health Services Research and department of Family Medicine, Care and Public Health Research Institute, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Sabrina Bajwah
3Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, United Kingdom
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Michele Hilton Boon
4WiSE Centre for Economic Justice, Glasgow Caledonian University, Glasgow, UK
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Courtney Coleman
5European Lung Foundation, Sheffield, United Kingdom
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David C. Currow
6Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
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Albert Devillers
7Association Belge Francophone contre la Fibrose Pulmonaire (ABFFP, French-speaking Belgian Association against Pulmonary Fibrosis), Belgium
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Chantal Vandendungen
7Association Belge Francophone contre la Fibrose Pulmonaire (ABFFP, French-speaking Belgian Association against Pulmonary Fibrosis), Belgium
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Magnus Ekström
8Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Respiratory Medicine, Allergology and Palliative Medicine, Lund, Sweden
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Ron Flewett
9Pulmonary Fibrosis Trust, Staffordshire, United Kingdom
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Sarah Greenley
10Institute for Clinical and Applied Health Research, Hull York Medical School, University of Hull, Hull, United Kingdom
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Mai-Britt Guldin
11Research Unit for General Practice, Aarhus, Denmark
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Cristina Jácome
12CINTESIS@RISE, Department of Community Medicine, Health Information and Decision, Faculty of Medicine of University of Porto, Porto, Portugal
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Miriam J. Johnson
13Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, United Kingdom
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Geana Paula Kurita
14Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
15Multidisciplinary Pain Centre, Department of Anaesthesiology, Pain and Respiratory Support, Neuroscience Centre and Palliative Research Group, Department of Oncology, Centre for Cancer and Organ Diseases, Rigshospitalet, Denmark
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Matthew Maddocks
3Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, United Kingdom
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Alda Marques
16Respiratory Research and Rehabilitation Laboratory (Lab3R), School of Health Sciences (ESSUA) and Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal
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Hilary Pinnock
17Allergy and Respiratory Research Group, Usher Institute, The University of Edinburgh, UK
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Steffen T. Simon
18University of Cologne, Faculty of Medicine and University Hospital, Department of Palliative Medicine and Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf (CIO ABCD), Germany
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Thomy Tonia
19Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
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Kristoffer Marsaa
20Department of multidisease, Nordsjaellands Hospital, University of Copenhagen, Denmark
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Abstract

There is increased awareness of palliative care needs in people with chronic obstructive pulmonary disease (COPD) or interstitial lung disease (ILD). This European Respiratory Society (ERS) task force aimed to provide recommendations for initiation and integration of palliative care into the respiratory care of adult people with COPD or ILD.

The ERS task force consisted of 20 members, including representatives of people with COPD or ILD and informal caregivers. Eight questions were formulated, four in the ‘Population, Intervention, Comparison, Outcome’ (PICO) format. These were addressed with full systematic reviews and application of Grading of Recommendations Assessment, Development and Evaluation (GRADE) for assessing the evidence. Four additional questions were addressed narratively. An ’evidence-to-decision’ framework was used to formulate recommendations.

The following definition of palliative care for people with COPD or ILD was agreed: A holistic and multidisciplinary, person-centred approach aiming to control symptoms, and improve quality of life of people with serious health-related suffering because of COPD or ILD, and to support their informal caregivers. Recommendations were made regarding people with COPD or ILD and their informal caregivers to: consider palliative care when physical, psychological, social, or existential needs are identified through holistic needs assessment; offer palliative care interventions, including support for informal caregivers, in accordance with such needs; offer advance care planning in accordance with preferences; and integrate palliative care into routine COPD and ILD care. Recommendations should be reconsidered as new evidence becomes available.

Footnotes

This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.

Conflict of interest: DJAJ reports lecture fees from Boehringer Ingelheim (personal), Chiesi (non-personal), AstraZeneca (non-personal) and Abbott (non- personal) within the previous three years outside the submitted work.

Conflict of interest: DC has received intellectual property payments and consultancy fees from Mayne Pharma International Pty Ltd, manufacturers of Kapanol and is a paid adviser to Helsinn Pharmaceuticals.

Conflict of interest: GPK has received grants from Novo Nordisk Foundation, the Danish Cancer Society and European Commission outside the submitted work.

Conflict of interest: HP has received speaker fees from Boehringer Ingelheim, Teva, and Sandoz for non-promotional talks on digital respiratory health and asthma supported selfmanagement.

Conflict of interest: KM reports lectures fees from Astellas Pharma, GlaxoSmithKline, AstraZeneca, Novartis, Boehringer Ingelheim, Kyowa Kirin, Norgine, Roche, Bristol-Myers Squibb, Chiesi Pharma outside the submitted work.

Conflict of interest: MM is supported by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration South London (NIHR ARC South London) at King's College Hospital NHS Foundation Trust. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

Conflict of interest: All other panellists have no conflicts of interest to report.

This is a PDF-only article. Please click on the PDF link above to read it.

  • Received October 17, 2022.
  • Accepted May 6, 2023.
  • Copyright ©The authors 2023. For reproduction rights and permissions contact permissions{at}ersnet.org
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European Respiratory Society Clinical Practice Guideline: Palliative care for people with chronic obstructive pulmonary disease or interstitial lung disease
Daisy J.A. Janssen, Sabrina Bajwah, Michele Hilton Boon, Courtney Coleman, David C. Currow, Albert Devillers, Chantal Vandendungen, Magnus Ekström, Ron Flewett, Sarah Greenley, Mai-Britt Guldin, Cristina Jácome, Miriam J. Johnson, Geana Paula Kurita, Matthew Maddocks, Alda Marques, Hilary Pinnock, Steffen T. Simon, Thomy Tonia, Kristoffer Marsaa
European Respiratory Journal Jan 2023, 2202014; DOI: 10.1183/13993003.02014-2022

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European Respiratory Society Clinical Practice Guideline: Palliative care for people with chronic obstructive pulmonary disease or interstitial lung disease
Daisy J.A. Janssen, Sabrina Bajwah, Michele Hilton Boon, Courtney Coleman, David C. Currow, Albert Devillers, Chantal Vandendungen, Magnus Ekström, Ron Flewett, Sarah Greenley, Mai-Britt Guldin, Cristina Jácome, Miriam J. Johnson, Geana Paula Kurita, Matthew Maddocks, Alda Marques, Hilary Pinnock, Steffen T. Simon, Thomy Tonia, Kristoffer Marsaa
European Respiratory Journal Jan 2023, 2202014; DOI: 10.1183/13993003.02014-2022
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