Coordination of end-of-life care for patients with lung cancer and those with advanced COPD: are there transferable lessons? A longitudinal qualitative study.
BACKGROUND
Care coordination is defined as good communication between professionals to enable access to services based on need.


OBJECTIVE
To explore patients' experience of care coordination in order to inform current debates on how best to coordinate care and deliver services in end-of-life for patients with lung cancer and those with chronic obstructive pulmonary disease (COPD).


METHODS
A qualitative study involving serial interviews was performed in 18 patients recruited from three hospital outpatient clinics situated in a hospital. Interviews were transcribed verbatim and data were analysed thematically.


RESULTS
Data comprised 38 interviews. Patients experiencing services related to lung cancer reported good access enabled by the involvement of a keyworker. This contrasted with COPD patients' experiences of services. The keyworker coordinated care between and within clinical settings, referred patients to community palliative care services, helped them with financial issues, and provided support.


CONCLUSIONS
For patients with lung cancer, the keyworker's role augmented access to various services and enabled care based on their needs. The experiences of patients with COPD highlight the importance of providing a keyworker for this group of patients in both secondary and primary care.
Department of Palliative Care Policy and Rehabilitation, Cicely Saunders Institute, King's College London, London, UK.
Eleni
E
Epiphaniou
Cathy
C
Shipman
Richard
R
Harding
Bruce
B
Mason
Scott A A
SA
Murray
Irene J
IJ
Higginson
Barbara A
BA
Daveson
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008175:Lung Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*; D036301:Qualitative Research; D012720:Severity of Illness Index; D013727:Terminal Care / Q000458:organization & administration*