 The healthcare needs of chronic obstructive pulmonary disease (COPD) patients in the last year of life Chronic obstructive pulmonary disease (COPD) causes almost as many deaths as
lung cancer, yet evidence about the impact of COPD in the latter stages of illness
is limited. These researchers assessed the healthcare needs of COPD patients
in the last year of life through a retrospective survey of the informants of
399 deaths from COPD in four London health programs between January and May
2001. Symptoms, day to day functioning, contact with health and social services,
formal and informal help with personal care, information received, and place
of death were assessed. Data was obtained on 209 (52%) deceased subjects (55%
male), average age at death was 76.8 years. Based on the reports of informants
of the deaths: 98% were breathless all the time or sometimes in the last year
of life; other symptoms reported all the time or sometimes included fatigue
or weakness (96%), low mood (77%) and pain (70%); breathlessness was partly
relieved in over 50% of those treated. Control of other symptoms was poor, with
low mood relieved in 8% and no treatment for low mood received by 82% of sufferers.
Patients who died from COPD lacked surveillance and received inadequate services
from primary and secondary care in the year before they died. Study investigators
conclude that the absence of palliative care services highlights the need for
research into appropriate models of care to address uncontrolled symptoms, information
provision, and end of life planning. Elkington H, White P, Addington-Hall J,
Higgs R, Edmonds P. Adapted from Palliative Medicine. 2005 Sep;19(6):485-91. |
| Department of Pain Medicine and Palliative Care Beth Israel Medical Center, New York City ©2005 Continuum Health Partners, Inc. www.stoppain.org/palliative_care |
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