title: Management of patients with end-stage chronic obstructive pulmonary disease.
abstract: Patients with end-stage chronic obstructive pulmonary disease (COPD) have poor quality of life, with limited activity, breathlessness, dependence on others, and recurrent needs for medical evaluation and treatment. Such patients demonstrate significant and progressive impairments in physical, mental, and social functioning. Because the rate of decline is variable, however, it is difficult to predict prognosis of survival. Currently available treatments only partially relieve symptoms, and patients become increasingly more disabled. This article reviews quality of life issues, proposed prognostic indicators, and pharmacologic and nonpharmacologic treatments in advanced COPD. Palliative measures to address breathlessness and unmet needs among patients with end-stage COPD are discussed.
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA. aberman@montefiore.org
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Berman
mesh_terms: D032722:Advance Care Planning / Q000458:organization & administration; D001007:Anxiety / Q000209:etiology; D015992:Body Mass Index; D001993:Bronchodilator Agents / Q000627:therapeutic use; D003863:Depression / Q000209:etiology; D005938:Glucocorticoids / Q000627:therapeutic use; D017051:Hospice Care / Q000458:organization & administration; D006801:Humans; D010102:Oxygen Inhalation Therapy; D010166:Palliative Care / Q000458:organization & administration*; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000523:psychology / Q000628:therapy*; D013510:Pulmonary Surgical Procedures; D011788:Quality of Life; D012121:Respiration, Artificial; D012720:Severity of Illness Index; D019452:Terminally Ill
chemical_list: D001993:Bronchodilator Agents; D005938:Glucocorticoids