End-of-life care for COPD patients.
Patients with chronic obstructive pulmonary disease (COPD) receive poor end-of-life (EoL) care, in part because their disease course is not predictable. If the family physician would not be surprised at the patient's death within a year, then EoL issues should be raised for discussion. Embarking on such a discussion has the potential to enhance the patient's quality of life and EoL care, thereby avoiding unnecessary treatments or interventions. An Advance Health Care Directive can be useful. Appropriately-used systemic (not nebulised) opioids are safe and effective for managing dyspnoea. The family physician is in an excellent position to provide comprehensive EoL care for COPD patients.
Dean
Mervyn M
MM
Palliative Care Department, Western Memorial Regional Hospital, Western Health Authority, Newfoundland & Labrador, Canada. mdean@healthwest.nf.ca
D032722:Advance Care Planning; D003142:Communication; D004417:Dyspnea / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D010166:Palliative Care / Q000379:methods*; D010817:Physician-Patient Relations; D011368:Professional-Family Relations; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life; D013727:Terminal Care