Communication about Palliative Care for Patients with Chronic Obstructive Pulmonary Disease

2005 ◽  
Vol 21 (3) ◽  
pp. 157-164 ◽  
Author(s):  
J. Randall Curtis ◽  
Ruth A. Engelberg ◽  
Marjorie D. Wenrich ◽  
David H. Au
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Palliative Care ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Physician Communication ◽  
High Morbidity ◽  
Obstructive Pulmonary Disease ◽  
Eol Care

Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality and disability Worldwide. For many patients, maximal therapy for COPD produces only modest relief of disabling symptoms and these symptoms result in a significantly reduced quality of life. Despite the high morbidity and mortality, patients with COPD do not receive adequate palliative care. One reason these patients may receive poor quality palliative care is that patient-physician communication about palliative and EOL care is unlikely to occur. The purpose of this review is to summarize recent research regarding patient-physician communication about palliative care for patients with COPD. Understanding the barriers to this communication may be an important step to improving communication about EOL care and improving patient-centred outcomes. Two areas that may influence the quality of care received by patients with COPD are also highlighted: 1) the role of depression, a common problem in patients with COPD, in physician-patient communication; and 2) the role of advance care planning in this communication. Further research is needed to develop and test interventions that can enhance patient-physician communication about palliative and EOL care for patients with COPD, and we describe our perspective on a research agenda in each area.

Palliative Care in End-Stage Chronic Obstructive Pulmonary Disease

2018 ◽  
Author(s):  
Linh My Thi Nguyen
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Palliative Care ◽  
Pulmonary Disease ◽  
Symptom Burden ◽  
Symptom Assessment ◽  
Poor Quality ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
End Stage

Patients with end-stage chronic obstructive pulmonary disease (COPD) experience high symptom burden due to severe dyspnea, fatigue, anxiety, depression, disability, and social isolation, resulting in poor quality of life. The caregiving burden for the family is also severe. Despite high symptom burden, because of limited access and difficulty with prognostication, the quality of care for patients with end-stage COPD who receive palliative care compares poorly to the care received by patients with cancer, and the proportion of COPD patients who receive palliative care is much lower than that of cancer patients. Therefore, patients with COPD receive less palliative care and die following more aggressive treatments at the end of life compared to patients with lung cancer, despite having the same preferences for palliative care. This chapter discusses the key issues related to end-stage COPD, including symptom assessment, management, and hospice eligibility.

scholarly journals Epidemiological profile of deaths from COVID-19 at a reference cardiology hospital and indication for palliative care during the pandemic

2021 ◽  
Vol 29 ◽  
pp. 1-5
Author(s):  
Louis Ohe ◽  
Italo Ferreira ◽  
Mateus Prata ◽  
Kelvin Vilava ◽  
Felipe Gindri ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Palliative Care ◽  
Pulmonary Disease ◽  
Cause Of Death ◽  
Chronic Obstructive ◽  
Imaging Data ◽  
Obstructive Pulmonary Disease ◽  
Significant Difference ◽  
Epidemiological Profile

Background Palliative care is a set of procedures for patients and families facing terminal or advanced illnesses. Numerous studies have already evaluated the role of palliative care and indications in outpatient or emergency settings. Nonetheless, data referring to the role of palliative care during a pandemic, such as COVID-19, are lacking. This study aimed to analyze the profile of deaths by COVID-19 at a tertiary reference cardiology hospital, and to identify the factors associated with more frequent indication of palliative care during patient management. Methods From March 1 to July 31, 2020, all deaths due to confirmed COVID-19 were analyzed, and their clinical, epidemiological, laboratory and imaging data were obtained. Results Considering the deaths, 26.8% of patients had received palliative care during hospitalization. When the groups were compared (standard care versus palliative care), there was a statistically significant difference for age (67.1±12.1 versus 73.5±9.1 years), presence of chronic obstructive pulmonary disease (3.2% versus 14.7%), and hypoxemia as cause of death (17.2% versus 55.9%). Conclusion In this analysis of patients admitted to the emergency room of a tertiary cardiology hospital during the pandemic period, the determining factors for higher indication for palliative care were age and previous chronic obstructive pulmonary disease. The main cause of death was hypoxemia, which was more prevalent in the palliative group.

scholarly journals ROLE OF NUTRITION IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE: A REVIEW

2021 ◽  
Vol 9 (11) ◽  
pp. 372-377
Author(s):  
Naveen Vennilavan ◽  
◽  
Gayathri a ◽  
Nisha Ganga ◽  
Meenakshi Narashiman ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Mucus Production ◽  
Obstructive Pulmonary Disease ◽  
Early Evaluation ◽  
Long Period ◽  
Copd Patients

Chronic obstructive pulmonary disease which mainly affects lung due to the inflammation in the airway and alveoli over a long period of time causing excessive mucus production and airway trapping. The majority of COPD patients are affected with nutrition depletion due to their systemic inflammation and multiple other factors. Malnutrition in Chronic Obstructive Pulmonary Disease affects the lung function, tolerance in exercise, and Quality Of Life. The early evaluation and treatment of malnutrition in COPD might aid in improving the morbidity and mortality.

scholarly journals Role of immunomodulators in treatment of chronic obstructive pulmonary disease

2019 ◽  
Vol 2 (27) ◽  
pp. 19-25
Author(s):  
A. A. Zuykova ◽  
O. N. Krasnorutskaya ◽  
Yu. A. Kotova ◽  
D. Yu. Bugrimov ◽  
N. V. Strakhova ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Steady Increase ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Cellular And Humoral Immunity ◽  
Relationship Of ◽  
The Relationship

Statistics from around the world show a steady increase in morbidity and mortality from chronic obstructive pulmonary disease. Currently, quite a promising direction is to assess the relationship of immunosuppression of the respiratory system and inflammatory response. Imbalance in the immune system often leads to recurrent, sluggish exacerbation of the disease, deterioration of prognosis and quality of life. The duration of the disease is directly related to more severe violations of cellular and humoral immunity. From this perspective, it is promising to assess the effectiveness of immunomodulators in the treatment of chronic obstructive pulmonary disease.

Role of exhaled nitric oxide in predicting steroid response in chronic obstructive pulmonary disease

2010 ◽  
Vol 151 (51) ◽  
pp. 2083-2088 ◽  
Author(s):  
Balázs Antus
Keyword(s):  
Nitric Oxide ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Exhaled Nitric Oxide ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Steroid Response

A kilégzett levegőben mérhető nitrogén-monoxid a legszélesebb körben vizsgált légúti biomarker. A stabil állapotú krónikus obstruktív tüdőbetegségben a kilégzett nitrogén-monoxid-szint hasonló vagy csak kismértékben emelkedett az egészségesekhez képest. Mivel a nitrogén-monoxid-szint szoros összefüggést mutat a légúti eosinophilia mértékével, és mivel az eosinophil típusú légúti gyulladás szteroidokra érzékenyebb, az emelkedett nitrogén-monoxid-szinttel rendelkező betegek jobb válaszkészséget mutatnak az inhalációs vagy szisztémás kortikoszteroidkezelésre. A krónikus obstruktív tüdőbetegség akut exacerbatiója során a kilégzett nitrogén-monoxid szintje megemelkedik, majd ennek kezelése után csökken. Mivel a nitrogén-monoxid-szint és a kezelés során elért légzésfunkciós javulás szoros korrelációt mutat egymással, a nitrogén-monoxid-méréssel a terápiás válasz megjósolható. Összefoglalva: a nitrogén-monoxid-méréssel a krónikus obstruktív tüdőbetegségben szenvedő betegek olyan alcsoportját lehet elkülöníteni, amelynek szteroidérzékenysége nagyobb. Orv. Hetil., 2010, 151, 2083–2088.

Participation of ABCA1 transporter in development of chronic obstructive pulmonary disease

2020 ◽  
Vol 28 (3) ◽  
pp. 360-370
Author(s):  
Stanislav N. Kotlyarov ◽  
Anna A. Kotlyarova
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Significant Contribution ◽  
Modern Medicine ◽  
Lipid Homeostasis ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Reverse Transport ◽  
Current Paradigm

Despite all achievements of the modern medicine, the problem of chronic obstructive pulmonary disease (COPD) does not lose its relevance. The current paradigm suggests a key role of macrophages in inflammation in COPD. Macrophages are known to be heterogeneous in their functions. This heterogeneity is determined by their immunometabolic profile and also by peculiarities of lipid homeostasis of cells. Aim. To analyze the role of the ABCA1 transporter, a member of the ABC A subfamily, in the pathogenesis of COPD. The expression of ABCA1 in lung tissues is on the second place after the liver, which shows the important role of the carrier and of lipid homeostasis in the function of lungs. Analysis of the literature shows that participation of the transporter in inflammation consists in regulation of the content of cholesterol in the lipid rafts of the membranes, in phagocytosis and apoptosis. Conclusion. Through regulation of the process of reverse transport of cholesterol in macrophages of lungs, ABCA1 can change their inflammatory response, which makes a significant contribution to the pathogenesis of COPD.

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