title: Consistency of medical record reporting of a set of indicators for proactive palliative care in patients with chronic obstructive pulmonary disease.
abstract: To identify patients hospitalized for an acute exacerbation of chronic obstructive pulmonary disease (COPD) who have a poor prognosis and might benefit from proactive palliative care, a set of indicators had been developed from the literature. A patient is considered eligible for proactive palliative care when meeting ≥2 criteria of the proposed set of 11 indicators. In order to develop a doctor-friendly and patient-convenient tool, our primary objective was to examine whether these indicators are documented consistently in the medical records. Besides, percentage of patients with a poor prognosis and prognostic value were explored. We conducted a retrospective medical record review of 33 patients. Five indicators; non-invasive ventilation (NIV), comorbidity, body mass index (BMI), previous admissions for acute exacerbation COPD and age were always documented. Three indicators; hypoxaemia and/or hypercapnia, professional home care and actual forced expiratory volume1% (FEV1%) were documented in more than half of the records, whereas the clinical COPD questionnaire (CCQ), medical research council dyspnoea (MRC dyspnoea) and the surprise question were never registered. Besides, 78.8% of the patients met ≥2 criteria and there was a significant association between meeting ≥2 criteria and mortality within 1 year (one-sided Fisher's exact test, p = 0.04). The set of indicators for proactive palliative care in patients with COPD appeared to be user-friendly and feasible.
authors.affiliation: 1 Department of Anaesthesiology, Pain and Palliative Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
authors.forename: Ria G
authors.initials: RG
authors.lastname: Duenk
authors.affiliation: 1 Department of Anaesthesiology, Pain and Palliative Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
authors.forename: Stans C
authors.initials: SC
authors.lastname: Verhagen
authors.affiliation: 1 Department of Anaesthesiology, Pain and Palliative Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
authors.forename: Mireille Ae
authors.initials: MA
authors.lastname: Janssen
authors.affiliation: 2 Department of Pulmonary Disease, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
authors.forename: Richard Pnr
authors.initials: RP
authors.lastname: Dekhuijzen
authors.affiliation: 1 Department of Anaesthesiology, Pain and Palliative Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
authors.forename: Kris Cp
authors.initials: KC
authors.lastname: Vissers
authors.affiliation: 1 Department of Anaesthesiology, Pain and Palliative Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Engels
authors.affiliation: 2 Department of Pulmonary Disease, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Heijdra
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015897:Comorbidity; D018450:Disease Progression; D004417:Dyspnea / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D005541:Forced Expiratory Volume; D006699:Home Care Services; D006760:Hospitalization; D006801:Humans; D006935:Hypercapnia / Q000209:etiology / Q000503:physiopathology*; D000860:Hypoxia / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008499:Medical Records / Q000592:standards*; D008875:Middle Aged; D009426:Netherlands; D063087:Noninvasive Ventilation; D010166:Palliative Care; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D012189:Retrospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
keywords: Chronic obstructive pulmonary disease; exacerbation; indicators; proactive palliative care; prognosis