scholarly journals Integrated palliative care networks from the perspectives of patients: A cross-sectional explorative study in five European countries

2018 ◽  
Vol 32 (6) ◽  
pp. 1103-1113 ◽  
Author(s):  
Marlieke den Herder-van der Eerden ◽  
Anne Ebenau ◽  
Sheila Payne ◽  
Nancy Preston ◽  
Lukas Radbruch ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Palliative Care ◽  
Confidence Interval ◽  
Pulmonary Disease ◽  
Odds Ratio ◽  
Healthcare Professionals ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Lower Odds

Background: Although examining perspectives of patients on integrated palliative care organisation is essential, available literature is largely based on administrative data or healthcare professionals’ perspectives. Aim: (1) Providing insight into the composition and quality of care networks of patients receiving palliative care and (2) describing perceived integration between healthcare professionals within these networks and its association with overall satisfaction. Design: Cross-sectional explorative design. Setting/participants: We recruited 157 patients (62% cancer, 25% chronic obstructive pulmonary disease, 13% chronic heart failure, mean age 68 years, 55% female) from 23 integrated palliative care initiatives in Belgium, Germany, the United Kingdom, Hungary and the Netherlands. Results: About 33% reported contact with a palliative care specialist and 48% with a palliative care nurse. Relationships with palliative care specialists were rated significantly higher than other physicians ( p < 0.001). Compared to patients with cancer, patients with chronic obstructive pulmonary disease (odds ratio = 0.16, confidence interval (0.04; 0.57)) and chronic heart failure (odds ratio = 0.11, confidence interval (0.01; 0.93)) had significantly lower odds of reporting contact with palliative care specialists and patients with chronic obstructive pulmonary disease (odds ratio = 0.23, confidence interval (0.08; 0.71)) had significantly lower odds of reporting contact with palliative care nurses. Perceptions of main responsible healthcare professionals or caregivers in patient’s care networks varied across countries. Perceived integration was significantly associated with overall satisfaction. Conclusion: Palliative care professionals are not always present or recognised as such in patients’ care networks. Expert palliative care involvement needs to be explicated especially for non-cancer patients. One healthcare professional should support patients in understanding and navigating their palliative care network. Patients seem satisfied with care provision as long as continuity of care is provided.

scholarly journals Palliative care integration for patients with advanced chronic obstructive pulmonary disease (COPD): Identifying essential components using participatory action research

2021 ◽  
pp. 026921632110289
Author(s):  
Tanja Fusi-Schmidhauser ◽  
Katherine Froggatt ◽  
Nancy Preston
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Palliative Care ◽  
Action Research ◽  
Participatory Action Research ◽  
Pulmonary Disease ◽  
Healthcare Professionals ◽  
Chronic Obstructive ◽  
Care Model ◽  
Participatory Action ◽  
Obstructive Pulmonary Disease

Background: Chronic obstructive pulmonary disease (COPD) is a life-limiting condition with palliative care needs. Despite increasing awareness about the role palliative care can play in care provision for patients with advanced COPD, integration in standard care remains underdeveloped. The unpredictability of the disease progression and misconceptions about palliative care being equivalent to end-of-life care often prevent a timely integrated approach in advanced COPD. Aim: To identify practices designed to increase integration of palliative care in the management of patients with advanced COPD in a respiratory service in Southern Switzerland. Design: A participatory action research approach was chosen and key stakeholders were involved to develop new knowledge and practices, supported by a Theory of Change framework. Data from each cycle and retrospective analysis at the end of the whole research were analysed using thematic analysis. Setting/participants: Five action research cycles with seven healthcare professionals working in palliative or respiratory care settings were conducted. Results: Three elements of integrated palliative care in advanced COPD were identified: multidimensional assessment, healthcare professionals’ education and interdisciplinary team meetings, which are the pillars of a new integrated palliative care model for patients with advanced COPD. Conclusions: The new integrated palliative care model in advanced COPD includes essential elements with a focus on patients, healthcare professionals and care delivery. Further research on testing this model in clinical practice, service development, implementation processes and possible outcomes, including evaluation of the financial impact of integrated palliative care is necessary to foster this care approach across all possible settings.

Chronic Obstructive Pulmonary Disease and Symptoms Related to Depression in Elderly Persons

1995 ◽  
Vol 76 (1) ◽  
pp. 287-297 ◽  
Author(s):  
Raimo Isoaho ◽  
Pekka Laippala ◽  
Timo Keistinen ◽  
Sirkka-Liisa Kivelä
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Confidence Interval ◽  
Pulmonary Disease ◽  
Odds Ratio ◽  
Marital Relationship ◽  
Primary Care Providers ◽  
Chronic Obstructive ◽  
Elderly Persons ◽  
Obstructive Pulmonary Disease ◽  
Female Patients

In a community study, 61 men and 21 women with mild to severe chronic obstructive pulmonary disease (COPD) were compared with age- and sex-matched controls (183 men and 63 women) to identify and analyze the associations between the occurrence of COPD and depressive symptoms, the occurrence of previous or current psychiatric disorders, the use of psychiatric drugs, and satisfaction with one's marital relationship. In men, no associations between COPD and the above factors were found. More women with COPD than controls reported feelings of dissatisfaction with life. The female patients also tended to be less satisfied with their marital relationship than the controls. Multivariate analysis showed that this disease in women was associated with disability (odds ratio 3.25, 95% confidence interval 1.17–9.06), feelings of dissatisfaction with life (odds ratio 3.56, 95% confidence interval 1.23–10.34), and low satisfaction with one's marital relationship (odds ratio 3.23, 95% confidence interval 1.10–9.47). These results seem to suggest that elderly female patients with COPD have more mental health problems than male patients and these will require more attention from the primary care providers.

Association Between Transient Opioid Use and Short-Term Respiratory Exacerbation Among Adults With Chronic Obstructive Pulmonary Disease: A Case-Crossover Study

2019 ◽  
Vol 188 (11) ◽  
pp. 1970-1976 ◽  
Author(s):  
Yiran Rong ◽  
John P Bentley ◽  
Gerald McGwin ◽  
Yi Yang ◽  
Benjamin F Banahan ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Confidence Interval ◽  
Pulmonary Disease ◽  
Odds Ratio ◽  
Chronic Obstructive ◽  
Administrative Claims ◽  
Opioid Use ◽  
Short Term ◽  
Obstructive Pulmonary Disease ◽  
Case Crossover

Abstract The association of historical opioid use with health care use and death among patients with chronic obstructive pulmonary disease (COPD) has been tested. Using Mississippi Medicaid data, we examined the association of transient or short-term opioid use and acute respiratory exacerbations among adults with COPD. We used a case-crossover design and 2013–2017 Mississippi Medicaid administrative claims data. A total of 1,972 qualifying exacerbation events occurred in 1,354 beneficiaries. The frequency and dose of opioid exposure in the 7 days before the exacerbation were examined and compared with the opioid exposure in 10 control windows, each 7 days long, before the exacerbation. Adjusted odds ratios were estimated using conditional logistic regression models to estimate the risk of opioid use on exacerbations after accounting for use of bronchodilators, corticosteroids, benzodiazepines, and β-blockers. Overall, opioid exposure in the 7 days before an exacerbation was significantly associated with acute respiratory exacerbation (odds ratio = 1.81; 95% confidence interval: 1.60, 2.05). Each 25-mg increase in morphine equivalent daily dose was associated with an 11.2% increase in the odds of an acute respiratory exacerbation (odds ratio = 1.11; 95% confidence interval: 1.04, 1.20). Transient use of opioids was significantly associated with acute respiratory exacerbation of COPD.

scholarly journals Is the 1-Minute Sit-To-Stand Test a Good Tool to Evaluate Exertional Oxygen Desaturation in Chronic Obstructive Pulmonary Disease?

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 159
Author(s):  
Ana L. Fernandes ◽  
Inês Neves ◽  
Graciete Luís ◽  
Zita Camilo ◽  
Bruno Cabrita ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Intraclass Correlation ◽  
Oxygen Desaturation ◽  
Walking Distance ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Stand Test ◽  
Sit To Stand

Background: Chronic obstructive pulmonary disease (COPD) is frequently associated with exertional oxygen desaturation, which may be evaluated using the 6-minute walking test (6MWT). However, it is a time-consuming test. The 1-minute sit-to-stand test (1STST) is a simpler test, already used to evaluate the functional status. The aim of this study was to compare the 1STST to the 6MWT in the evaluation of exertional desaturation. Methods: This was a cross-sectional study including 30 stable COPD patients who performed the 6MWT and 1STST on the same day. Six-minute walking distance (6MWD), number of 1STST repetitions (1STSTr), and cardiorespiratory parameters were recorded. Results: A significant correlation was found between the 6MWD and the number of 1STSTr (r = 0.54; p = 0.002). The minimum oxygen saturation (SpO2) in both tests showed a good agreement (intraclass correlation coefficient (ICC) 0.81) and correlated strongly (r = 0.84; p < 0.001). Regarding oxygen desaturation, the total agreement between the tests was 73.3% with a fair Cohen’s kappa (κ = 0.38; p = 0.018), and 93.33% of observations were within the limits of agreement for both tests in the Bland–Altman analysis. Conclusion: The 1STST seems to be a capable tool of detecting exercise-induced oxygen desaturation in COPD. Because it is a less time- and resources-consuming test, it may be applied during the outpatient clinic consultation to regularly evaluate the exercise capacity and exertional desaturation in COPD.

scholarly journals Correlation between 6-minute walk distance and spirometry parameters in stable chronic obstructive pulmonary disease patients

2018 ◽  
Vol 7 (1) ◽  
pp. 34
Author(s):  
Ruchita B. Hajare ◽  
Raziya Nagarwala ◽  
Ashok Shyam ◽  
Parag Sancheti
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Strong Positive Correlation ◽  
Walk Test ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Six Minute Walk Test ◽  
Tertiary Center ◽  
Minute Walk

Background: Six minute walk test (6MWT) is a sub-maximal exercise test, used as a clinical indicator of the functional capacity, in patients with cardiopulmonary diseases. It is simple, objective and reproducible test. The present study was designed to assess correlation of six minute walk test with spirometry parameters, in patients with chronic obstructive pulmonary disease.Methods: In this cross sectional study, fifty patients diagnosed with chronic obstructive pulmonary disease (GOLD criteria) coming to tertiary center were recruited according to inclusion and exclusion criteria. All patients underwent spirometric measurement. Spirometric indices including FEV1, FVC, FEV1/FVC and MVV were tested using computerized spirometer. 6MWT was performed following American Thoracic Society (ATS) guidelines. Percent (%) predicted 6MWD was calculated. Correlation between spirometry and 6MWT was assessed.Results: It was found that correlation between 6MWT and spirometry is statistically significant. There is significant strong positive correlation between percent predicted 6MWD and FEV1 (r=0.850 and p= <0.001), whereas there is significant moderate correlation between percent predicted 6MWD and FVC (r=0.554 and p= <0.001), FEV1/FVC (r=0.509 and p= <0.001) and MVV (r=0.615 and p= <0.001).Conclusions: In chronic obstructive pulmonary disease, percent predicted 6mwd significantly correlated with the spirometry parameters (FEV1, FVC, FEV1/FVC, and MVV). 6MWD decreases as there is decline in the pulmonary function. 6MWT can be a useful replacement of spirometry in assessment of severity of COPD.

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